Original Paper

Head Accelerations during Particle Repositioning Manoeuvres
M.E. Faldon, A.M. Bronstein

Department of Clinical Neuroscience, Division of Neuroscience and Mental Health, Imperial College, London, UK

Address of Corresponding Author

Audiol Neurotol 2008;13:345-356 (DOI: 10.1159/000136153)

  Key Words

• Benign paroxysmal positional vertigo
• Particle repositioning manoeuvres
• Hallpike manoeuvre
• Epley manoeuvre
• Semont manoeuvre

  Abstract

Benign paroxysmal positional vertigo (BPPV) due to canalithiasis can be treated with particle repositioning manoeuvres, which aim to evacuate trapped particles from the semicircular canals (SCC). The movement of particles within the SCC is affected by gravity as well as by the accelerations of the head during the manoeuvres. Moreover, as experienced by the particles, gravity is indistinguishable from an upward acceleration of the SCC in free space. We used a set of three orthogonal linear accelerometers to measure the net three-dimensional linear acceleration vector acting on the head during the Hallpike manoeuvre and Epley and Semont particle repositioning manoeuvres (which are used to treat posterior canal BPPV). The projection of the net acceleration vector onto the SCC planes showed that both the Epley and Semont manoeuvres approximated to stepwise, 360°, backward rotations in the plane of the targeted posterior canal. Angular velocity measurements however showed that the rotational component during the central stages of these two manoeuvres is opposite in direction. A simple model of head rotations during particle repositioning manoeuvres was created which showed good agreement to the linear acceleration measurements. Analysis of modelled and measured data identified that speed of movement during the Semont manoeuvre should be critical to its clinical success.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Dr. M.E. Faldon
Department of Clinical Neuroscience, Division of Neuroscience and Mental Health
Imperial College, Charing Cross Hospital
Fulham Palace Road, London W6 8RF (UK)
Tel. +44 20 8846 7349, Fax +44 20 8383 3630, E-Mail m.faldon@imperial.ac.uk

  Article Information

Received: August 3, 2007
Accepted after revision: February 20, 2008
Published online: June 5, 2008
Number of Print Pages : 12
Number of Figures : 10, Number of Tables : 1, Number of References : 18