The examiner then quickly rotates the head 90° to the right side and checks again for vertigo and nystagmus. In this roll test, the person may experience vertigo and nystagmus on both sides, but rotating toward the affected side will trigger a more intense vertigo. Similarly, when the head is rotated toward the affected side, the nystagmus will beat toward the ground and be more intense.As mentioned above, both the Dix–Hallpike and roll test provoke the signs and symptoms in subjects with archetypal BPPV. The signs and symptoms people with BPPV experience are typically a short-lived vertigo and observed nystagmus. In some people, although rarely, vertigo can persist for years. Assessment of BPPV is best done by a medical health professional skilled in the management of dizziness disorders, commonly a physiotherapist, audiologist, or other physician.The nystagmus associated with BPPV has several important characteristics that differentiate it from other types of nystagmus. Latency of onset: there is a 5–10 second delay prior to onset of nystagmus
Nystagmus lasts for 5–60 seconds
Positional: the nystagmus occurs only in certain positions
Repeated stimulation, including via Dix–Hallpike maneuvers, cause the nystagmus to fatigue or disappear temporarily
Rotatory/torsional component is present, or (in the case of lateral canal involvement) the nystagmus beats in either a geotropic (toward the ground) or ageotropic (away from the ground) fashion
Visual fixation suppresses nystagmus due to BPPVAlthough rare, CNS disorders can sometimes present as BPPV.
In the following step, the patient remains lying but lifts their head with the chin close to the chest. In the last step, the patient sits upright with the head in the normal position. Before going to the next step, one has to wait until the nystagmus fully resides ( typical 30 to 60 seconds ) and progression from one step to the next has to happen in a fluid movement. Semont maneuver
The Semont maneuver has a cure rate of 90.3%. It is performed as follows:

The person is seated on a treatment table with their legs hanging off the side of the table. The therapist then turns the persons head 45 degrees toward the unaffected side. The therapist then quickly tilts the person so they are lying on the affected side. The head position is maintained, so their head is turned up 45 degrees. This position is maintained for 3 minutes. The purpose is to allow the debris to move to the apex of the semicircular duct. The person is then quickly moved so they are lying on the unaffected side with their head in the same position (now facing downward 45 degrees). This position is also held for 3 minutes. The purpose of this position is to allow the debris to move toward the exit of the semicircular duct. Finally, the person is slowly brought back to an upright seated position.