[Repositioning maneuver in benign paroxysmal vertigo of horizontal semicircular canal]

The introduction of the Lempert or Baloh "barbecue" maneuver in clinical practice has resolved many cases of paroxysmal positional vertigo of the horizontal semicircular canal. Unfortunately, this maneuver is rather difficult to perform in elderly or overweight patients and in those with reduced mobility. In such cases the Vannucchi "forced position" is the maneuver of choice. Diagnostic confirmation is, however, still a problem. The authors feel diagnosis is only confirmed when the positional nystagmus has been converted, inverted or disappears after the physical therapy maneuver. For this reason another maneuver has been developed and is described in the present work. Between May 10th and November 28th 1997 thirty cases of horizontal canalolithiasis were seen: 19 in the right vestibule, 11 the left vestibule (9 males, 21 females; age range 20 to 82 years). Of these cases, 24 (4 apogeotropic, 20 geotropic) were treated with a maneuver differing from the barbecue maneuver. Some parts of this maneuver are similar to the Semont maneuver, moving the patient from a seated position to a position on the right or left side, depending the pathology and type of vertigo (geotropic/apogeotropic). A favorable outcome was achieved in 22 cases and there was no result in 2 cases. The two non-responsive patients were then treated with forced positioning which resolved the condition. Benign paroxysmal positional vertigo from horizontal canalolithiasis responds to treatment with the above-mentioned maneuver.