Movement of the cupula by endolymph can cause either a stimulatory or an inhibitory response, depending on the direction of motion and the particular semicircular canal. The ampulla contains the cupula, a gelatinous mass with the same density as endolymph, which in turn is attached to polarized hair cells. Each canal is filled with endolymph and has a swelling at the base termed the ampulla. The 3 semicircular canals in the inner ear detect angular acceleration and are positioned at near right angles to each other. The vestibular system monitors the motion and position of the head in space by detecting angular and linear acceleration. Its symptoms are repeated episodes of positional vertigo, that is, of a spinning sensation caused by changes in the position of the head.
This disorder is caused by problems in the inner ear. īenign paroxysmal positional vertigo ( BPPV) is a specific type of vertigo that is brought on by a change in position of the head with respect to gravity. Apogeotropic describes the nystagmus as a horizontal beat towards the ceiling. Geotropic describes the nystagmus as a horizontal beat towards the ground. Additionally, the type of nystagmus that a patient may display can be classified as geotropic or apogeotropic.
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Cupulolithiasis is when the otoconia are adhered to the cupula, whilst canalithiasis is when the otoconia are free floating in the canal. īPPV can be classified as cupulolithiasis and canalithiasis. With the displacement of the otoconia into the semicircular canals, these delicate feedback loops relay conflicting signals that can result in any symptom related to BPPV. Visual perception such as gravity, position, and movements also receive signals from somatosensory receptors in the peripheral vestibules. They respond to movement and relay signals via the eighth cranial nerve. The peripheral vestibular labyrinth contains sensory receptors in the form of ciliated hairs in the three semicircular canals and in the ear’s otolithic organs.
It should be noted that the superior canal is sometimes also referred to as the anterior canal and the horizontal canal is sometimes referred to as lateral canal. The posterior canal is the most commonly affected site, but the superior and horizontal canals can be affected as well. These semicircular canals are sensitive to gravity and changes in head position can be a trigger for BPPV. Though not fully understood, BPPV is thought to arise due to the displacement of otoconia (small crystals of calcium carbonate) from the maculae of the inner ear into the fluid-filled semicircular canals. Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo, which is a symptom of the condition.
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