Which maneuver is commonly used to treat BPPV?

Which maneuver is commonly used to treat BPPV?

• A. Canalith repositioning (Epley) maneuver
• B. Brandt-Daroff exercises
• C. Semont maneuver
• D. Vestibular rehabilitation therapy

Answer: (A)

Repositioning loose otoconia back into the utricle is the treatment aim in BPPV, and the most commonly used maneuver to achieve that is the canalith repositioning maneuver (Epley). This sequence guides the head and body through positions that move calcium carbonate crystals out of the posterior semicircular canal and into the utricle, where they no longer trigger vertigo with routine head movements. It’s favored because it’s straightforward, well tolerated, and often provides quick relief after a few repetitions, and it can be performed in a clinic or at home with instruction. Brandt-Daroff exercises are home habituation maneuvers that may help reduce vertigo over time but don’t actively reposition the canaliths, so they’re not as effective for immediate correction. The Semont maneuver is another repositioning option and can be effective for certain patterns of BPPV, but it can be more vigorous and isn’t as universally preferred as the first-line Epley sequence. Vestibular rehabilitation therapy is a broader program aimed at promoting compensation for vestibular weakness and imbalance, rather than directly moving the displaced otoconia.

Repositioning loose otoconia back into the utricle is the treatment aim in BPPV, and the most commonly used maneuver to achieve that is the canalith repositioning maneuver (Epley). This sequence guides the head and body through positions that move calcium carbonate crystals out of the posterior semicircular canal and into the utricle, where they no longer trigger vertigo with routine head movements. It’s favored because it’s straightforward, well tolerated, and often provides quick relief after a few repetitions, and it can be performed in a clinic or at home with instruction.

Brandt-Daroff exercises are home habituation maneuvers that may help reduce vertigo over time but don’t actively reposition the canaliths, so they’re not as effective for immediate correction. The Semont maneuver is another repositioning option and can be effective for certain patterns of BPPV, but it can be more vigorous and isn’t as universally preferred as the first-line Epley sequence. Vestibular rehabilitation therapy is a broader program aimed at promoting compensation for vestibular weakness and imbalance, rather than directly moving the displaced otoconia.