1. Repositioning treatment for benign positional vertigo resulting from canalolithiasis. In the example shown, repositioning maneuvers are used to move endolymphatic debris out of the posterior semicircular canal (PSC) of the right ear and into the utricle (UT), the larger of two membranous sacs in the vestibule of the labyrinth, where this debris can be reabsorbed. The numbers (1-6) refer to both the position of the patient and the corresponding location of debris within the labyrinth. The patient is seated, and the head is turned 45 degrees to the right (1). The head is lowered rapidly to below the horizontal (2); the examiner shifts position (3); and the head is rotated rapidly 90 degrees in the opposite direction, so it now points 45 degrees to the left, where it remains for 30 seconds (4). The patient then rolls onto the left side without turning the head in relation to the body and maintains this position for another 30 seconds (5) before sitting up (6). This maneuver may need to be repeated until nystagmus is abolished. The patient must then avoid the supine position for at least 2 days. (Used with permission from Baloh RW and from Samuels MA, Feske SK, eds. Office Practice of Neurology. New York, NY: Churchill Livingstone; 1995.)
Source: Disorders of Equilibrium, Clinical Neurology, 9e
Citation: Aminoff MJ, Greenberg DA, Simon RP. Clinical Neurology, 9e; 2015 Available at: Accessed: October 22, 2017
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