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Canalith Repositioning Maneuvers

A canalith repositioning procedure can help relieve benign paroxysmal positional vertigo (BPPV), a condition which causes brief but intense episodes of dizziness that occur when moving one’s head. Vertigo usually comes from a problem with the part of the inner ear responsible for balance. BPPV occurs when tiny particles called otoconia in one part of the inner ear break loose and fall into the canals of the inner ear.

Canalith repositioning moves the otoconia to a part of the ear where they won’t cause dizziness.


How does it work?

The canalith repositioning procedure involves holding four positions for about 30 to 45 seconds each. Typically, patients remain in each position an extra 20 seconds after symptoms have stopped. The procedure may be repeated three or more times within a treatment session.

Depending on the physician’s preferences, the patient may wear an infrared imaging device over his or her eyes. This device helps the health provider examine the eyes during each maneuver.

During canalith repositioning:

  • Patients move from a sitting to a reclining position with the head turned to the affected side by 45 degrees. The physician will help extend the patient’s head over the edge of the table at a slight angle.
  • With the head still extended over the edge of the table, the patient will turn his or her head slowly away from the affected side by about 90 degrees.
  • The patient will roll onto his or her side while keeping the head angled and looking down at the floor. Your head should be slightly angled while you look down at the floor.
  • Patients return carefully to a sitting position with the head tilted down and returned to the center position.

Am I a good candidate for treatment?

Anyone with BBPV who can go through the procedure safely may benefit from it. If BBPV returns after CRP, the procedure can be used again to treat recurrences.