Which physical therapy treatment would MOST benefit a patient with Benign Paroxysmal Positional Vertigo?

• A. Dix-Hallpike Maneuver
• B. Canalith Repositioning Maneuvers
• C. Singular Neurectomy
• D. Gaze Stability Exercises

Answer: (B)

Benign paroxysmal positional vertigo is caused by otoconia that have wandered into a semicircular canal, where head movements cause abnormal endolymph flow and brief vertigo. The treatment that most directly addresses this mechanical issue is canalith repositioning maneuvers (such as the Epley or Semont). These procedures use specific head and body positions to guide the loose crystals back into the utricle, where they won’t trigger symptoms, often resolving vertigo after one or a few treatments.

The Dix-Hallpike maneuver is used to diagnose BPPV by provoking vertigo and nystagmus, not to treat. Gaze stability exercises target vestibulo-ocular reflex adaptation for other vestibular conditions and won’t remove the canaliths. Singular neurectomy is an invasive surgical option not indicated for BPPV.