Atypical instability without signs characteristic of clinically most frequent rotatory vertigo may manifest some form of otolith disturbance. Standard functional diagnostics of the vestibular apparatus examines only functions of semicircular canals, therefore patients with a disorder of otoliths can be misdiagnosed and considered as suffering from a functional disease. This article has summed up the present view of the problems of pathophysiology and symptomatology of otolith disorders. The authors have tried to explain the most common subjective difficulties as well as typical findings revealed in the course of clinical examinations, and to elucidate the pathophysiology of each deficit. There is also given the anatomico-physiological description of otolith structures and a list of diseases involving otolith disorders. The mentioned facts should facilitate the diagnostics of diseases affecting otolith structures.

        Key words: otoliths, otolith disorders, linear vertigo, vestibulo-ocular reflex, skew deviation syndrome, ocular tilt reaction, subjective visual vertical, Wallenberg’s syndrome, nystagmus