Three days after the initial fitting of the cochlear device a 40-year-old w
oman complained of severe rotational vertigo following head movements assoc
iated with neurovegetative symptoms. Otoneurological evaluation revealed a
horizontal paroxysmal positional nystagmus beating towards the lowermost ea
r, induced by rolling the patient's head from supine both to the right or t
o the left lateral position suggesting the diagnosis of benign paroxysmal p
ositional vertigo of the left horizontal semicircular canal. The nystagmus
characteristics were the same whether the cochlear device was switched on o
r off. The hypothesis of an otolith dislodging due to the electrical stimul
ation during the initial fitting is discussed.