Lateral rotations of the head



Patient lies supine with the pathological ear downward.

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Head is quickly turned 90 degrees upward and then 90 degrees further to bring the pathological ear uppermost.  



The patient's head returns slowly to the initial position (supine with the pathologic ear downward).  



This motion can be repeated.  



Theory:  Quick movement is expected to move otoliths away from the cupula by inertial forces, and the slow movement is thought to complete the migration toward the utricle by gravitational forces.  



Indicated for canalithiasis, cupulolithiasis questionable.



Healthy ear downward may be more effective for cupulo (get more info on this).  



Riga, M., Korres, S., Korres, G., & Danielides, V. (2013). Apogeotropic variant of lateral semicircular canal benign paroxysmal positional vertigo: Is there a correlation between clinical findings, underlying pathophysiologic mechanisms and the effectiveness of repositioning maneuvers. Otology & Neurotology, 00(00), 1-10.



  

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