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Semont liberatory manoeurve for BPPV

Semont Manoeuvre
The diagram shows the manoeuvres you should use to induce dizziness (so as to eventually be cured of it).  You may find the dizziness less troublesome if you perform this exercise with your eyes closed.   Infrequently dizziness may recur.  In this instance the exercise regime should be performed again.  In an outpatient study of 18 patients 70% experienced complete relief of their dizziness within 3 to 14 days and most within 7 to 10 days.  All patients noted a gradual improvement in their dizziness from the 1st or 2nd day.  There are occasional exceptions to this.  If the symptoms do persist despite conscientious performance of the exercises, your condition should be reviewed.

To do the exercises each ear should be treated in turn, unless you are clear that it is with your head turned to one side that causes your vertigo.  If you are not sure do the exercises for both ears. 

In the following exercise it is important that stages 1 and 2 (shown in the pictures below) are performed as quickly as possible. The principle of different positions is to turn your head 45° away from the direction in which you are to fall and for your head to be maintained in the same 45° angle throughout the whole manoeuvre. This is best done by having someone hold your head to maintain the 45° angle  throughout the positioning manoeuvre.

For symptoms related to the right ear follow the instructions below:



1. Turn your head 45 degrees  to the Left.

2. Fall down quickly onto your right shoulder (shown in the picture), still keeping your head at 45 degrees to the left.

3. Wait 1 minute in this position. Do not move your head from the 45 degree position.

4.Then in one quick and uninteruppted movement keeping your head at the same 45 degrees move all the way across onto your left shoulder. 

5. Again, wait 1 minute, without moving your head.

6. With your head still at 45 degrees, swing yourself back to an upright position.

For the symptoms related to the left ear:


1. Turn your head 45 degrees to the Right. 

2. Moving quickly to your left, perform Stage 1, then follow steps 3-6 outlined above.

If you feel dizzy at the end of both Stage 1 and Stage 3 be encouraged, you may have moved the material out of the canal.  These exercises should be done daily until the dizziness no longer occurs.  Stop the exercises as soon as you are free of vertigo.  There is a 40% chance of recurrence over 30 months. Keep this sheet handy so you can refer to it again.