😠 🛑 Difficult BPPV (presenting either with torsional upbeat nystagmus toward affected side or downbeat nystagmus in the Dix-Hallpike test) that won’t change with a modified Epley or classic Semont/Liberatory maneuver? Consider the Demi-Semont maneuver! 💎 💪 The Demi-Semont has been proposed as an option to treat atypical short-arm posterior canal BPPV. In short-arm posterior canalithiasis, the Demi-Semont may clear the BPPV altogether, or it may reposition debris into the long arm of the cana