The Light Cupula: An Emerging New Concept for Positional Vertigo

Author: Min Beom KIM ¹ ; Seok Min HONG ; Hyerang CHOI ; Seongjun CHOI ; Ngoc Chien PHAM ; Jung Eun SHIN ; Chang Hee KIM
Author Information

1. Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Publication Type:Review
Keywords: Light cupula; Positional vertigo; Head-roll test; Direction-changing positional nystagmus; Null plane
MeSH: Benign Paroxysmal Positional Vertigo; Diagnosis; Ear; Head; Nystagmus, Physiologic; Semicircular Canals; Supine Position; Vertigo
From:Journal of Audiology & Otology 2018;22(1):1-5
CountryRepublic of Korea
Language:English
Abstract: Benign paroxysmal positional vertigo (BPPV) is the most common type of positional vertigo. A canalolithiasis-type of BPPV involving the lateral semicircular canal (LSCC) shows a characteristic direction-changing positional nystagmus (DCPN) which beats towards the lower ear (geotropic) on turning the head to either side in a supine position. Because geotropic DCPN in LSCC canalolithiasis is transient with a latency of a few seconds, the diagnosis can be challenging if geotropic DCPN is persistent without latency. The concept of “light cupula” has been introduced to explain persistent geotropic DCPN, although the mechanism behind it requires further elucidation. In this review, we describe the characteristics of the nystagmic pattern in light cupula and discuss the current evidence for possible mechanisms explaining the phenomenon.