Semontmanoeuvre

The Semont manoeuvre, also called the liberatory manoeuvre, is a physical therapy technique used to treat benign paroxysmal positional vertigo (BPPV), most commonly due to debris in the posterior semicircular canal. The goal is to move otoliths (calcium carbonate crystals) from the canal into the utricle, where they no longer provoke vertigo with head movements.

Indications for the Semont manoeuvre include canalithiasis of the posterior semicircular canal. It is one of several canalith repositioning maneuvers used to treat BPPV and is often offered when symptoms are clearly linked to specific head positions. It is generally well tolerated but may be contraindicated in cases of severe neck or spine problems, acute neck injury, vertebral artery disease, or other conditions where rapid head movements could be risky.

The procedure involves a sequence of rapid head and body movements performed with the patient seated. The clinician turns the head to the affected side, then rapidly moves the patient to lie on the side opposite the affected ear with the head angled to direct gravity through the posterior canal. After a brief hold, the patient is quickly moved to lie on the other side, continuing to orient the head to encourage debris to move into the utricle. The maneuver is typically completed with the patient returning to an upright seated position.

Effectiveness varies, but the Semont manoeuvre is a common first-line treatment for posterior canal BPPV and can relieve vertigo after one or a few sessions. Side effects are usually transient, including brief vertigo or nausea during the maneuver.