Vestibular pathophysiology during vertiginous attacks was discussed on the basis of clinical observations and basic research, and was summarized as follows:
1) Essential differences between cochlear damage and vestibular damage were noted. Cochlear symptoms were signs of the affected side cochlea. However, vestibular symptoms were caused by functional imbalance of the vestibular organs between the affected side and the normal side. The process of disturbance in the vestibular organ on the affected side showed two different stages: first, irritation, then paralysis. However, in the cochlear damage, there was only a paralytic state without any sign of initial irritation. Investigation of these differences is very important to clarify the discrepancy between vestibulo-cochlear symptoms and inner ear pathology.
2) The labyrinth progressed through 4 states during the process of peripheral vertigo: a) the disturbed stage, b) the recovery stage, c) the compensatory stage, and d) the revival stage.
Treatment for peripheral vertigo should be selected according to the state of labyrinth, and discrimination methods of the labyrinthine state were discussed.
