Treatment of benign positional vertigo using heels-over-head rotation

Particle repositioning, using either bedside techniques or whole-body manip ulation devices, has been used effectively to treat benign positional verti go (BPV). We assessed the efficacy of particle repositioning using a device designed and built specifically to treat BPV that rotated patients 360 deg rees heels-over-head in their sagittal body plane while their heads were tu rned to align the posterior semicircular canal with the plane of rotation. Eye movements were monitored during the maneuver by an infrared video recor ding system that allowed subsequent review of the induced nystagmus. Our re sults indicate that 1) heels-over-head rotation is an extremely efficacious procedure for treating patients with BPV and 2) the pattern of nystagmus d uring repositioning is consistent with the theory that free-floating debris is highly likely to account for BPV.