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Horizontal Canal Treatment - BBQ Roll

Your Dix Hallpike test showed a horizontal beating nystagmus that reversed with head position changes. Your therapist will determine through video oculography if you have positional vertigo of the lateral or horizontal canal, what side and what part of the canal. This determination can only occur through imaging. This video shows the BBQ Roll maneuver from Fauquier ENT.

Horizontal Canal Treatment


The most important part of treating positional vertigo of a horizontal canal is to use liberating techniques prior and during the rolling procedure. Rolling alone does not have as a high success for treatment compared to using techniques to 'loosen up' the crystal.


Flop down onto a firm pillow 4-5 times with your head turned away or toward the pillow as determined by you therapist onto the involved side. The most important part of this treatment is the stop. You want your head to stop abruptly and quickly on the pillow.


If you have a right sided horizontal canal positional vertigo you will start the procedure onto the right side.




Place a hand held massager behind your ear over the bone, partway up. (Right side for a right horizontal canal.) You will know you are on the right spot when it triggers your vertigo. This is the spot that you can massage wtih each head position for 10-20 seconds prior to you turning your head.


Tips for successful treatment


  • Hold each position for 45 seconds or until vertigo subsides.
  • Keep your head still with each position.
  • Quickly turn your head for each position. Too slow and it will cause the crystal to fall back into the canal.
  • You know you are better if you get an immediate relief of your vertigo.


After the BBQ Roll


For the next 2 nights avoid sleeping on the affected side. You can also sleep upright if this is easier for you.


If your vertigo returns after it is clear repeat the BBQ roll.


What do I do if it doesn’t work?


If after two tries and your vertigo is not getting better then repeat imaging to determine if you have positional vertigo is recommended. Your dizziness may be coming from your neck as this can also cause a horizontal nystagmus.

Here is information to check out for the best way to test for vertigo.

Horizontal Canal Treatment - BBQ Roll