Challenging Vestibular Case: Therapists Please Offer Your Help


Post from:
Corporate Rehabilitation Physical Therapy supervisor

I’ve had 2 recent patients with right posterior canalithiasis where there is a short latency, F/B approx 15-20sec right upward torsional nystagmus and c/o vertigo

The CRM maneuver was done with both patients w/o incident.  Though, it’s come back with both of them.  I’ve done the maneuver about 3x each, but it’s not resolved

The one patient is 80 y/o and the onset idiopathic and the second patient is 34 y/o and post concussion(also w/HA’s, but the migraine food diary did not show a + trigger pattern)

Do you have any recommendations for further tx?