1:  Patient begins in long sitting



2:  Patient is moved into supine with neck extended (at least 30 degrees).  

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3:  Nystagmus down beating indicates involvement of the anterior canal.  There may or may not be a torsional component (Bertholon, Bronstein, Davies, rudge, & Thilo, 2002)



Rational:  

Due to the orientation of the anterior canal, additional extension may be required to produce a nystagmus.  This technique allows for about 20 degrees additional extension, as a 45 degree rotation is not required (Bertholon, Bronstein, Davies, rudge, & Thilo, 2002).