Rapidly move into side-lying position on the affected side.
Rapidly move to patients unaffected side with the nose 45° upward
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 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
The patient should experience vertigo when moved to the face-down position. If not, it is often useful to perform a slight headshake in an effort to loosen otolithic
Procedure
Begin with the patient sitting on the examination table, facing the examiner, with the patient’s head turned toward the affected side at a 45º angle
Guide the patient into a side-lying position on the affected side. (This should be a rapid movement and the patient’s nose should be pointing)
Hold this position for 2-3 minutes
While maintaining the 45º head position, guide the patient in a continuous motion from side-lying on the affected side to side-lying on the unaffected (The patient’s nose should be pointing upward)
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 Benign paroxysmal positional vertigo. Laryngoscope. 1997;107:607-613