Treatment of benign paroxysmal positional vertigo: No need for postmaneuver restrictions

The liberatory maneuver of Semont is an effective physical treatment for be nign paroxysmal positional vertigo. It works because it causes otoconia to move out the posterior canal. The effectiveness of the maneuver is thought to be indicated by the appearance of a liberatory nystagmus. After the mane uver, patients are usually instructed to keep their heads erect for several days and not to lie on the pathologic side for about a week. Here we inves tigated the prognostic value of liberatory nystagmus and whether restrictio ns are necessary after treatment, Fifty-six patients with posterior canal b enign paroxysmal positional vertigo underwent the Semont maneuver and were checked after 20 minutes, 24 hours, and 1 week. The patients were told that they could sleep or move as they pleased, without any particular precautio ns. We found that liberatory nystagmus had a high prognostic value and that it was not necessary for patients to avoid certain positions or movements after treatment.