BPPV treatment Flashcards
Treatment for L posterior canalithiasis
Perform CRM with frenzels
1 go to Supine dix Hallpike position to L
Symptoms resolve + 30 seconds
2 Slowly rotate pt head to R (unaffected side)
Symptoms resolve + 30 seconds
3 rotate to sidelying on R(unaffected side) and tuck chin so nose is pointed to floor (dump position)
Symptoms resolve + 30 seconds
Keep head in same position and sit up
Symptoms resolve + 30 seconds
Straighten head
What should a patient do after CRM treatment
Perform self-CRM every morning until vertigo free For 3 days in a row
Treatment at home for R posterior canalithiasis
Sit up with pillow behind back
Lie down and turn head to right (pillow allows you to be in dix hallpike position)
Turn head to R (unaffected side)
Roll to R sidelying while tucking chin and pointing nose to ground
Return slowly to sitting
Straighten head
(Symptoms must resolve + 30 seconds in between each step )
Treat R posterior cupulolithiasis
Must perform Semont maneuver
Pt sits at edge w/ head turned 45 degrees opposite to the affected side (to the L)
Pt quickly drops to sidelying on R side (affected side)
(in between these steps position the patients head to be flexed 30 degrees)
Pt quickly is moved to sidelying on the unaffected side (L) in an arch, now nose is down with head flexed 30 degrees
Pt slowily sits up keeping head flexed
Pt returns head to neutral
1 minute between each step!
treat anterior canalithiasis or cupulolithiasis on the R
Need to perform the reverse semont
Pt sits at edge of mat w/ head turned 45 degrees TOWARDS affected side (R)
Pt is moved quickly onto affected side w/ nose pointed down
Pt is moved to opposite sidelying position quickly with head facing upward at a 45 degree angle
Pt slowily returns to sitting but keep head flexed
Pt straigthens head
1 minute between positions!
How often do patients need to perform a Semont for cupulolithiasis at home?
3-5 reps a day until vertigo free for 3 consecutive days
have patients record intensity of symptoms
Treat L Horizonal Canalithiasis
Perform BBQ Roll
begins in roll-test position w/ head flexed 30 degrees and turned 90 degrees towards effected ear (Supine facing the L)
slowily rotates head 90 degrees while keeping 30 degrees flexion (up)
slowily rotates head 90 degrees while keeping 30 degrees flexion (R)
roll head and body 90 degrees to the R) to face prone with neck flexed 30 degrees. Have patient propped up on pillow and forearms under chest
roll head 90 degrees to have affected side facing down (L ear on mat)
slowily rolls head and body back to affected side (L sidelying) while maintaining 30 degrees of neck flexion
Slowily sit up while keeping head flexed to 30 degees
slowily return back to neutral
30 seconds after symptoms resolve between each step
Treat R Horizontal canal Cupulolithiasis
Need to perform the Casani
Start with pt sitting at edge of mat, head in neutral
ask pt to quickly lie down on affected side (side of weaker apogeotropic nystagmus) while PT maintains neutral head position for TWO MINUTES
Quickly rotate patients head 45 degrees away from affected side (nose up) and hold TWO MINUTES
slowily return to sitting with head in same position (turned 45 degrees) TWO MINUTES
Return head to neutral
HEP for L horizontal canalithiasis
start by lying on affected ear (head turned L in supine)
Then lie on your back for 1 minute
quikcly roll so that you’re lying on your unaffected ear and sleep
in the morning roll onto stomach
roll back to lying on affected ear
get your ass up
1 minute between each step
