By Marcello Cherchi, MD PhD
Dr. Francisco Carlos Zuma e Maia developed the Zuma maneuver for apogeotropic lateral canal benign paroxysmal positional vertigo (BPPV) (Zuma e Maia 2016).
The Figure below, illustrates the right-sided Zuma maneuver for right-sided apogeotropic BPPV.

The Zuma maneuver for treating right-sided apogeotropic lateral canal BPPV is described by Zuma (Zuma e Maia 2016) as follows:
- The patient begins in a seated, neutral position.
- The patient quickly lies down on the affected (right) side, maintaining the head midline, and maintains this position for 3 minutes.
- The patient rotates the head 90 degrees to the patient’s unaffected (left) side (toward the sky) and maintains this position for another 3 minutes.
- The patient moves the body into a dorsal decubitus position and the head is turned 90 degrees toward the patient’s unaffected (left) side and maintains this position for 3 minutes.
- The patient’s head is tilted slightly forward.
- The patient slowly returns to a seated, neutral position.
The Figure below, from Ramos and colleagues (Ramos et al. 2022), perhaps more clearly illustrates the Zuma maneuver for right-sided apogeotropic lateral canal BPPV.

Zuma maneuver, apogeotropic lateral canal BPPV, right side, videos
The Zuma maneuver has been studied in a prospective randomized trial against the Appiani maneuver (Correia et al. 2022).
References
Correia F, Castelhano L, Cavilhas P, Escada P (2022) Lateral semicircular canal-BPPV: Prospective randomized study on the efficacy of four repositioning maneuvers. Acta Otorrinolaringol Esp (Engl Ed) 73: 27-34. doi: 10.1016/j.otoeng.2020.11.002
Ramos BF, Cal R, Mangabeira Albernaz PL, Zuma EMF (2022) Practical approach for lateral canal benign paroxysmal positional vertigo. J Neurol Sci 434: 120180. doi: 10.1016/j.jns.2022.120180
Zuma e Maia F (2016) New Treatment Strategy for Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo. Audiol Res 6: 163. doi: 10.4081/audiores.2016.163
![]()