How are the canalithiasis and cupulolithiasis forms of benign paroxysmal positional vertigo (BPPV) defined?

Updated: Mar 13, 2020
  • Author: John C Li, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Although some controversy exists regarding the 2 pathophysiologic mechanisms, canalithiasis and cupulolithiasis, agreement is growing that the entities actually coexist and account for different subspecies of BPPV. Canalithiasis (literally, "canal rocks") is defined as the condition of particles residing in the canal portion of the SCCs (in contradistinction to the ampullary portion). These densities are considered to be free floating and mobile, causing vertigo by exerting a force. Conversely, cupulolithiasis (literally, "cupula rocks") refers to densities adhered to the cupula of the crista ampullaris. Cupulolith particles reside in the ampulla of the SCCs and are not free floating.

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