How to perform repositioning for vertigo caused by otolithiasis

Benign paroxysmal positional vertigo (BPPV) is a condition that causes brief episodes of dizziness and nystagmus when the patient's head moves into a specific position. When vertigo occurs due to BPPV, treatments such as the Epley maneuver, Lempert rolling maneuver, Semont maneuver, medication, or surgical intervention can help reposition the displaced otoliths.

1. Epley Maneuver

The patient is quickly moved from a sitting position to a supine position, with the head rotated 45° outward so that the affected ear faces downward. Then, the head is turned 90° so that the healthy ear faces downward. Each position should be maintained until dizziness subsides before proceeding to the next position.

2. Lempert Rolling Maneuver

The patient lies in a supine position and performs three consecutive 90° rolls toward the unaffected side. After each rapid change in head position, the head remains fixed until dizziness resolves, typically for about one minute.

3. Semont Maneuver

The patient rapidly moves from a sitting position to a lateral decubitus position, turning the head 45° toward the unaffected side and holding this position for a period of time, then repeating the movement in the opposite direction.

4. Medication

Under medical supervision, calcium channel blockers such as nifedipine tablets, felodipine tablets, or amlodipine besylate tablets may be prescribed to help relieve symptoms.

5. Surgical Treatment

If the condition is severe or symptoms persist despite the above treatments, surgical options such as posterior semicircular canal occlusion or vestibular neurectomy may be performed under the guidance of a specialist to alleviate symptoms.

It is recommended to seek timely medical evaluation at a hospital, undergo thorough examination to determine disease severity, and receive appropriate treatment under professional medical guidance.