Theories ofPathophysiology

• Canalithiasis Theory: free-floating debris (dislodged otoconia) in the endolymph of the posterior canal moves when placed in a dependent position, the inertial drag of the endolymph causes displacement of the cupula resulting in latent vertigo which resolves when the debris settles

• Cupulolithiasis Theory: debris (calcium carbonate) adheres to the cupula of the semicircular canal resulting in an ampulla that is gravity sensitive (objections to theory include no account for the transient nature of vertigo and the torsional nystagmus exhibited in BPPV)

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