The ENT physician suspects that post trauma he has had cervical injury, and that the dizziness may be cervical.

• What is cervical vertigo?  How could this relate to unilateral weakness?

Hallpike testing is positive, now several months after the VNG test, with left posterior canal affected.  The Semont maneuver was conducted and the patient was instructed in doing that maneuver at home.

• What is the Semont maneuver, and how is it different from the Epley?

The ENT suspects concussive cochlear / vestibular damage from the motor vehicle accident, but notes that noise history may contribute to the hearing loss asymmetry.  He thinks the ear pain may be radiating pain from the cervical injury.  He ordered CT scans, but they were not obtained.

The patient returned 1 month later reporting he is still quite vertiginous and there is further reduction in cervical range of motion.  He reports that the Semont maneuvers are not improving his dizziness.  He was counseled on fall prevention, not driving, and was referred to a different physical therapy group in a nearby city, with more experience in treating dizzy patients.