1.  Patient sits in short sitting on the side of the treatment table.  



2.  The head is turned 45 degrees to the side opposite of the canal being examined (example:  If right canal is being examined, patient turns their head to the left).  



3.  The patient quickly lies down on the side opposite of their turned head, so they are facing upward (Example:  If right canal is being examined, patient moves onto their right side).



4.  Nystagmus is observed.  Upward torsional nystagmus indicates posterior canal involvement of downward side, and downward torsional nystagmus indicates anterior canal involvement of downward side.



5.  Slowly bring the patient to sitting (guard closely as patient may have symptoms of vertigo), and assess contralateral side.  

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Adopted from Herdman, S. J., 2007.