Head-Tilt Hopping Exercise for Lateral Cupulolithiasis

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Hopping with Head Tilt has been described as an effective treatment for cupulolithiasis of the lateral canal cupula. It is sometimes effective as an in-clinic treatment with demonstrated immediate elimination of the persistent ageotropic horizontal nystagmus. When the problem is eliminated in the clinic the pathologic nystagmus will either disappear or convert to geotropic horizontal nystagmus, depending on whether the otoliths are released from the utricular or canal side of the cupula. The exercise can also be performed at home with 20 hops with right and left head tilt, repeated 5 times daily.

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