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Semont Maneuver for the left Posterior Canal BPPV

Vestibular Diagnosis and Treatment
A Physical Therapy Approach

Treatment of the left posterior canal:

Turn the head 45° to the right side. Rapidly move into side-lying position on the affected side.  Rapidly move to patients unaffected side with the nose 45° down.

Helpful Hints:

  • 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 possible neurological symptoms occur during the execution of positioning maneuvers, discontinue the procedure IMMEDIATELY and refer for a neurological evaluation. These symptoms might include: blurred vision, numbness, weakness of the arms or legs or confusion.
  • The patient should experience vertigo when moved to each position. If not, it is often useful to perform a slight headshake in an effort to loosen otolithic debris.

Procedure:

  • Begin with the patient sitting on the examination table, facing the examiner, with the patient’s head turned away from the affected side at a 45° angle
  • Guide the patient into a side-lying position toward the affected side. (This should be a rapid movement and the patient’s nose should be pointing upward.)
  • Hold this position for 2-3 minutes
  • While maintaining the 45° head position, guide the patient in a continuous motion from side-lying on the affected side to side-lying on the unaffected side. (The patient’s nose should be pointing downward toward the table.)
  • Hold this position for 3-5 minutes
  • Guide the patient back into a sitting position

References:
Semont, Freyss G, Vitte E. Curing the BPPV with a liberative maneuver. Adv Otorhinolaryngol. 1998;42:290-3

Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope. 1997;107:607-613 

March 2017
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