Rapidly move to a Side-lying position on the unaffected side.
Quickly position head at a 45-degree angle with nose pointing down.
Before performing any form of positioning maneuver, it is important to ascertain whether the patient has current or past injuries of the neck or spine.
If any neurological symptoms occur during the execution of positioning maneuvers, discontinue the procedure immediately and refer for neurological evaluation. These symptoms might include, blurred vision, numbness, weakness of the arms or legs or confusion.
This procedure is an alternative treatment for patients who cannot complete the Lempert 360º Roll, as well as for cases where an apogeotropic lateral canal variant may be present.
Gufoni maneuver procedure
Begin with the patient sitting on the edge of the examination table, facing the examiner.
With a rapid motion, guide the patient into a side-lying position toward the unaffected side.
While the patient is lying on his side, with a quick movement, turn the patient’s head to a 45º angle (so that the patient’s nose is pointing toward the table).
Hold this position for 2-3 minutes.
Guide the patient back into a sitting position.
Gufoni M, Mastrosimone I, DiNasso Repositioning maneuver in benign paroxysmal positional vertigo of the horizontal semicircular canal. Acta Otorhinolaryngol Ital 1998;18:363-7
Appiani GC, Catania G, Gagliardi A liberatory maneuver for the treatment of horizontal canal paroxysmal positional vertigo. Otology and Neurology 22:66-69, 2001
Hughes CA, Proctor Benign paroxysmal positional vertigo. Laryngoscope. 1997;107:607-613.