Posterior Canal - BPPV: Epley and Semont Maneuvers

𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Epley/canalith repositioning maneuver (CRP) To treat right posterior canal (PC)-BPPV (each position maintained for at least 30 seconds or until nystagmus and/or vertigo cease): • First the patient is placed in the long-sitting position • The head is rotated 45 degrees to the right • Then the patient is lowered quickly into the supine position with the head in 30 degrees of cervical extension • Then the patient's head is 90 degrees to the left • The patient is rolled into a left-side lying position with the head maintained in 45 degrees of rotation to the left so that the head is facing the floor • Then the patient sits up slowly with the head still facing down towards the floor and rotated 45 degrees to the left • Slowly, the head is moved back to neutral Semont maneuver To treat right posterior canal (PC)-BPPV: • The patient is placed in a seated position on the treatment table • The head is turned 45 degrees to the left • The patient is quickly brought into a right side-lying position which is maintained for 1 minute • The patient is then guided quickly from right to left side-lying positions within 1.5 seconds without stopping in the center • The head is maintained in 45 degrees of leftward rotation so that the head is facing the ground and this is position is held for 1 minute • The patient is guided into a seated position slowly with the head maintained in 45 degrees of leftward rotation • The head is moved slowly back to neutral 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: (1) Epley/canalith repositioning maneuver (CRP)-to treat right posterior canal (PC)-BPPV (each position maintained for at least 30 seconds or until nystagmus and/or vertigo cease): (a) First the patient is placed in the long-sitting position, (b) The head is rotated 45 degrees to the right, (c) Then the patient is lowered quickly into the supine position with the head in 30 degrees of cervical extension, (d) Then the patient's head is 90 degrees to the left, (e) The patient is rolled into a left-side lying position with the head maintained in 45 degrees of rotation to the left so that the head is facing the floor, (f) Then the patient sits up slowly with the head still facing down toward the floor and rotated 45 degrees to the left, (g) Slowly, the head is moved back to neutral. (2) Semont maneuver-to treat right posterior canal (PC)-BPPV: (a) The patient is placed in a seated position on the treatment table, (b) The head is turned 45 degrees to the left, (c) The patient is quickly brought into a right side-lying position which is maintained for 1 minute, (d) The patient is then guided quickly from right to left side-lying positions within 1.5 seconds without stopping in the center, (e) The head is maintained in 45 degrees of leftward rotation so that the head is facing the ground and this is position is held for 1 minute, (f) The patient is guided into a seated position slowly with the head maintained in 45 degrees of leftward rotation, (g) The head is moved slowly back to neutral https://collections.lib.utah.edu/details?id=187680. (Video created with the assistance of Drs. Michael Schubert, Amir Kheradmand, and Laura Morris)