Methods: Presentation of a clinical case consistent with CSL-related BPPV due to a heavy dome, and a review of the literature.

Results: A patient presenting with positional vertigo who, whilst seated, exhibited unremitting spontaneous right nystagmus, which intensified with cervical extension and reversed with cervical flexion. In the supine position, she continued to exhibit right-sided, non-exhaustible nystagmus, which intensified with 90° left head rotation and reversed with 90° right head rotation. A neutral position was identified at 30° right head rotation. The Gufoni manoeuvre and head shaking proved ineffective. After one month, the patient continued to exhibit the same characteristics of nystagmus, without vertigo.