The subjective visual vertical in benign paroxysmal positional vertigo. A preliminary study.

In Benign Paroxysmal Positional Vertigo (BPPV), the existence of otoconial debris in the cupula or canal explains most of the symptoms and signs characteristic of this common inner ear disorder. We have studied the ability of patients with BPPV to correctly determine the subjective visual vertical, as this is a good test to evaluate utricular function. Only 1 of 10 patients with BPPV displayed a clearly abnormal response, and there was no correlation between the side of the lesion and the perceived tilt. This might imply that the limited damage induced by the dislodged otoconia does not disrupt utricular function or that the saccule is the source of the problem.