[Pathophysiology of peripheral, paroxysmal benign position vertigo].

Peripheral paroxysmal, benign positional vertigo is one of the most common peripheral vestibular disorders. According to the "cupulolithiasis hypothesis", it is assumed that inorganic material is attached to the cupula of the posterior vertical canal which renders this organ sensitive to gravitational forces rather than angular accelerations. Quantitative and well-controlled positioning manoeuvres, however, show that the characteristics of this kind of vertigo and the corresponding nystagmus cannot be explained by gravitation-dependent cupular reactions. It seems more probable that the typical symptoms are caused by disturbed utricular functions leading to disinhibited responses of the posterior vertical canal to adequate stimuli.