II. Indications
-
Benign Paroxysmal Positional Vertigo (BPPV) affecting the anterior semicircular canal (superior canal)
- Procedure is diagnostic and therapeutic
III. Technique
- Patient moves from seated position to lying supine
- Patient's head should overhang the end of the table
- Patient should extend their neck as much as possible (at least 30 degrees), so they are looking at the wall behind them
- Observe for Downbeat Nystagmus (Vertical Nystagmus) as patient moves into this position
- Vertical Nystagmus is otherwise a sign of cerebellar lesion (perform a careful Neurologic Exam)
- Nystagmus may also be torsional toward the affected ear
- Maneuver
- Patient remains supine with neck extended for 3 minutes
- Next, patient flexes their neck (chin to chest) as much as possible for 3 minutes
- Completion
- Assist the patient back to a seated position
IV. Resources
- Anterior Canal BPPV (YouTube, Peter Johns, MD)