Ending Vertigo Today

Why is HBPPV such a problem?

Here’s a photograph of the cupula of a mouse, taken by Dr. Olivia Kalmanson at the University of Colorado. The cupula looks dark green because it’s transparent, so the background can be seen right through it. To make it easier to see, we’ve piled otoconia, the gravity sensor’s crystals, on the middle of it. They are indenting it like a pile of rocks would indent a trampoline. At the bottom of the picture is the crista, the base of attachment of the cupula that contains all the nerves and sensory cells that make the inner ear able to sense spinning.

Cupulolithiasis in BPPV: Rare, or non-existent?

Newsflash: Read our science article, Cupulolithiasis: A Critical Reappraisal, at http://doi.org/10.1002/oto2.38

BPPV is the best understood form of vertigo, and usually goes away promptly with simple maneuvers. Sometimes, though, it can persist, and in those cases, a somewhat different and rare form is diagnosed, called cupulolithiasis. This means “stones on the cupula”, the cupula being the main sensor of the inner ear. In the time before we knew that ear stones—otoconia—moved freely in the ear canals causing vertigo, there was a theory that all the symptoms of BPPV were caused by otoconia that were attached to the sensor itself. Does this really happen?

A common malformation: Enlarged vestibular aqueduct syndrome (EVAS)

Since the inner ear is a pressure sensor, it is important to keep the pressures steady in the ear. This is a challenge because the ear bridges the space in the skull between the outside-the ear canal—and the inside, housing the brain. When you sneeze or strain, the pressure in the fluid around the brain rises. When your ears pop, it means the pressure of the air outside the skull has changed. Somehow the inner ear has to deal with these changes and keep functioning smoothly.