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.