12
Treatment
Figure 4. Semont Liberatory maneuver for treatment of
right posterior semicircular canal BPPV
Table 8. Stepwise Description of the Performance of the
Semont Liberatory Maneuver (right ear affected)
Step Action
1 Start with the patient sitting on a table or flat surface with head turned away
from the affected side.
2 Quickly put the patient into the side-lying position, toward the affected side
with the head turned up. Nystagmus will occur shortly aer arriving at the side-
lying position. Keep the patient in this position until at least 20 seconds aer all
nystagmus has ceased (some recommend up to 1–2 minutes).
3 Quickly move the patient back up and through the sitting position so that he or
she is in the opposite side-lying position with head facing down (head did not
turn during the position change). Keep the patient in this position for about 30
seconds (some recommend 2–10 minutes).
4 At a normal or slow rate, bring the patient back up to the sitting position.
Adapted and reproduced with permission from Fife et al. ©2008 Barrow Neurological Institute,
Phoenix, Arizona.
