Central Positional Vertigo

When the position of the head is brought to an off-vertical, lateral or head-hanging position a change in graviceptive (otholithic?) input occurs. This change is the precipitating factor for central positional vertigo. The most probable explanation for this response is a vestibular tone imbalance with directional positional nystagmus and rotational/linear vertigo caused by disinhibition of the vestibular reflexes on perception, eye, head, and body position (Brandt 1990). Thus, it is not (as one might speculate) the dislocation of the brain and intracerebral structures that depend on head position which causes the manifestations.