Posterior Canal BPPV Treated with Semont Maneuver

This is a patient with left posterior canal (PC) benign paroxysmal positional vertigo (BPPV), and upbeat-torsional (towards the left ear) nystagmus was provoked by left Dix-Hallpike maneuver and left side-lying maneuver. This video demonstrates treatment of her left PC BPPV with the Semont maneuver. First, in a seated position on the treatment table, her head was turned 45 degrees to the right, and she was quickly brought into the left side-lying position. Typical upbeat-torsional (towards the left ear) nystagmus was seen as the result of (excitatory) ampullofugal flow of otoconial particles and endolymph. This position is usually maintained for about 1 minute. She was then moved quickly from left to right side-lying positions with her head in the same position (45 degrees to the right). This position is also held for about 1 minute, and then the patient is slowly guided back to seated position and the head is moved back into a neutral position. During the right side-lying position, mainly torsional (beating towards the left ear) nystagmus can be seen as the otoconia and endolymph continue to travel in the ampullofugal direction. In the video, she is looking to the left, and since she is looking into the direction of the left posterior canal plane, the nystagmus looks mainly torsional. Although this is not shown in the video, by having her look to the right, this would be roughly perpendicular to the left posterior canal plane, and nystagmus would look mainly upbeat. [[Number of Videos and legend for each: A patient with posterior canal BPPV treated with Semont maneuver]]