The Bascule Maneuver for BPPV | How It Successfully Treated Persistent Vertigo

The Bascule Maneuver for BPPV | How It Successfully Treated Persistent Vertigo In this video, I present a challenging case of Benign Paroxysmal Positional Vertigo (BPPV) in an 82-year-old patient involving the right posterior semicircular canal. The examination begins with the Dix–Hallpike maneuver, which reveals a robust upbeating nystagmus with a torsional component to the right, confirming right posterior canal BPPV. A standard Epley maneuver is performed first, followed by a tapping-assisted Epley maneuver when the initial attempt fails to resolve the condition. Despite these interventions, follow-up testing shows persistent nystagmus, indicating that the otoconia remain within the posterior canal. Due to the refractory nature of this case, a more dynamic and aggressive approach — the Bascule maneuver — is performed in the LARP plane (Left Anterior–Right Posterior). After several rapid pivots with precise head alignment, a final Dix–Hallpike test confirms complete resolution, with no observable nystagmus. This case highlights how difficult posterior canal BPPV can sometimes be and emphasizes the importance of selecting the appropriate maneuver when standard treatments fail. This video is especially valuable for: Physical Therapists Chiropractors Vestibular Rehabilitation Specialists Medical Students and Clinicians ⏱️ Time Stamps 00:02 – Dix–Hallpike maneuver and diagnosis of right posterior canal BPPV 01:06 – Epley maneuver: first position (right side) 01:45 – Epley maneuver: second position (head rotated 90° to the left) 02:10 – Epley maneuver: third position (left side, head angled 45° downward) 02:55 – Return to upright sitting position 03:13 – Control Dix–Hallpike test (persistent nystagmus observed) 04:53 – Tapping-assisted Epley maneuver initiated 05:38 – Continued Epley maneuver with mastoid tapping 07:18 – Follow-up Dix–Hallpike test (BPPV still present) 08:04 – Bascul maneuver performed in the LAR plane 08:43 – Dynamic pivoting with strict head alignment 09:36 – Final Dix–Hallpike test: no nystagmus (successful outcome) ⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️ ⚡️ Connect with us: 🌐 Website: [https://laryngolog-konin.pl/] 📧 Email: [laryngologkonin@gmail.com] 📸 Instagram:   / zawroty_glowy_w_praktyce   🔵  / otoneurologiapraktyczna   ⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️ ⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️ 🎬 𝐖𝐀𝐓𝐂𝐇 𝐎𝐔𝐑 𝐎𝐓𝐇𝐄𝐑 𝐕𝐈𝐃𝐄𝐎𝐒: ▶️    • Why “benign” is part of Benign Paroxysmal ...   ▶️    • BPPV, Cupulolithiasis in the left horizont...   ▶️    • BPPV, Cupulolithiasis in the left horizont...   ▶️    • How quickly can you perform a diagnostic m...   ⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️⬆️ 👉 Watch until the end to see how a complex BPPV case was successfully resolved. 🔔 Subscribe to the channel for more clinical demonstrations, vestibular assessments, and advanced treatment techniques. #BPPV #VertigoTreatment #EpleyManeuver #DixHallpikeTest #BasculManeuver #VestibularRehab #PosteriorCanalBPPV #Nystagmus #BalanceDisorders #VertigoRelief #PhysicalTherapy #ChiropracticCare #ClinicalCase #Neurology #ENT #InnerEar #DizzinessTreatment #MedicalEducation #Physiotherapy #Healthcare