Benign paroxysmal positional vertigo pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Pathophysiology

Physiology

The normal physiology of semicircular canals can be understood as follows:

• One of the most important inner ear structures are horizontal, superior (anterior) and posterior semicircular canals.
• There is an osseous ampullae at the end of each semicircular canal which consist of ampulla crest, the crista ampullaris, and hair cells.
• Semicircular canals are hollow structures with endolymph inside them.
• The movement of endolymph following changing head position will stimulate hair cells to send an impulse to the brain, determining the head position.
• The horizontal semicircular canal detects the head movement in the transverse plane (head turning to right and left).
• The superior (anterior) semicircular canal detects head rotational movement in the sagittal plane (head nodding).
• The posterior semicircular canal detects head rotational movement in the coronal plane (head touching the shoulders)

Pathogenesis

• It is understood that BPPV is the result of free floating calcium carbonate crystal formation (canalolithiasis) inside the semicircular canals.
• These debris are normally attached to the membrane of utriculus, a gravity-sensitive structures in the inner ear.
• Movement of these otoconia with head movement will result in inappropriate stimulation of hair cells following movement of the endolymph.
• The inappropriate impulses to the brain will result in false sensation of spinning.

Genetics

[Disease name] is transmitted in [mode of genetic transmission] pattern.

OR

Genes involved in the pathogenesis of [disease name] include:

• [Gene1]
• [Gene2]
• [Gene3]

OR

The development of [disease name] is the result of multiple genetic mutations such as:

• [Mutation 1]
• [Mutation 2]
• [Mutation 3]

Associated Conditions

Conditions associated with [disease name] include:

• [Condition 1]
• [Condition 2]
• [Condition 3]

Gross Pathology

On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].