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Case Report

Physical Therapy Management of a Patient with Anterior Canalithiasis using the Deep Head Hanging Maneuver

Amer Al Saif1 and Eric G. Johnson2*
1Department of Physical Therapy, King Abdulaziz University, Jeddah, KSA
2Department of Physical Therapy, Loma Linda University, Loma Linda, CA, USA
Corresponding Author : Eric Johnson
Loma Linda University, 24951 North Circle Drive
Nichol Hall 1900, Loma Linda, CA 92350, USA
Tel: (909) 558-4632 ext. 47471
Fax: (909) 558-0459
E-mail: ejohnson@llu.edu
Received June 04, 2012; Accepted July 09, 2012; Published July 13, 2012
Citation: Al Saif A, Johnson EG (2012) Physical Therapy Management of a Patient with Anterior Canalithiasis using the Deep Head Hanging Maneuver. J Nov Physiother 2:117. doi: 10.4172/2165-7025.1000117
Copyright: © 2012 Al Saif A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

A 61-year-old female patient presented with a chief complaint of chronic vertigo that started suddenly four months ago. Her symptoms included intermittent nausea and position related vertigo. The left Hallpike-Dix test produced the patient’s vertigo and nausea. Weak left torsional downbeat nystagmus of approximately 10 seconds duration was also observed. The straight head hanging (HH) test was subsequently performed and it produced multiple beats of robust left torsional downbeat nystagmus of approximately 30 seconds duration. The patient was diagnosed with left anterior canalithiasis, which is a type of benign paroxysmal positional vertigo (BPPV). The deep head hanging maneuver (DHM) was performed and the patient reported feeling better immediately afterward. The HH test was performed again within a couple of minutes and the patient reported 80% resolution of both her vertigo and nausea. The patient was seen the following day and reported 100% resolution of symptoms. Her symptoms remained resolved at a 1 week follow-up. Based on the limited research concerning the examination and intervention methods described in this single subject case report, further research including controlled clinical trials are needed.

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