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February 1996

Cupulolithiasis and Canalolithiasis Are Two Photos of a Story Called 'The Destiny of the Otoconia'

Author Affiliations

Brussels, Belgium

Arch Otolaryngol Head Neck Surg. 1996;122(2):206-207. doi:10.1001/archotol.1996.01890140090022

I was preparing my thesis for graduation from a faculty of medicine. The subject I chose was on benign paroxysmal positional vertigo (BPPV). I did a retrospective study of 201 cases.

I learned that it was Barany1 in 1921 who described BPPV for the first time. Dix and Hallpike2 brought further precisions and introduced the diagnostic maneuver. Schuknecht3 introduced cupulolithiasis for explaining the syndrome. Hall et al4 proposed canalolithiasis because the first theory did not explain the different characteristics of BPPV.

Some authors have compared cupulolithiasis with positional alcohol nystagmus (PAN) and since the former presents differently from PAN, they questioned the validity of cupulolithiasis. It seems that there are some differences between the two phenomena. On one hand, BPPV is a progressive phenomenon, the deposition of particles is limited to a small part of the cupula, and there is no direct central effect in cupulolithiasis.

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