Otolithic dizziness is caused by dislodgment of otolith particles, adhering to the semicircular canals, induced by sudden changes in head position. Otolithiasis, also known as benign paroxysmal positional vertigo (BPPV), is a peripheral vestibular disorder induced by a change in head position relative to the direction of gravity with transient heavenly sensations as the main clinical manifestation and accompanied by autonomic symptoms such as nausea and vomiting. There are usually two different types of mechanisms regarding the pathogenesis of BPPV. 1. Dislodgment of otolith particles: due to the phenomenon of dislodgment, otolith particles on the cystic plaque of the ellipsoid capsule enter into the lumen of the semicircular canals. If the position of the head of the human body changes in relation to the direction of gravitational deviation at this time, the particles will be moved by gravitational force, and friction occurs on the walls of the canals. At the same time, the structure of the crest of the juxtaocardial ridge and the crista cap will be deviated, which can lead to dizziness because of the state of flow of the endolymph. 2. Adhesion of otolith particles: Because of the adhesion of otolith particles on the crural cap of the jugular ridge, the density of the crural cap of the jugular ridge in the lymphatic system will change, and therefore, its sensitivity to gravity will change, which will ultimately lead to the occurrence of dizziness. BPPV is self-limiting but prone to recurrence, and is the most common form of positional vertigo in the elderly. If symptoms are severe, prompt medical attention is recommended.