American Board of Internal Medicine (ABIM) Certification Practice Exam

Which maneuver is effectively used to treat benign paroxysmal positional vertigo?

1. Epley maneuver

2. Semont maneuver

3. Surgical intervention

4. BPPV repositioning technique

The correct answer is: Epley maneuver

The Epley maneuver is an effective treatment for benign paroxysmal positional vertigo (BPPV) because it specifically addresses the underlying cause of this condition, which is the displacement of otoliths (calcium carbonate crystals) within the inner ear. In BPPV, these crystals can migrate into the semicircular canals, leading to episodes of vertigo triggered by certain head movements. The Epley maneuver involves a series of guided head and body positions designed to facilitate the movement of these dislodged crystals back to their correct location within the utricle, where they no longer cause symptoms. The procedure typically includes sequential movements starting from the affected ear, moving the patient from a sitting position to lying back and then rotating the head. This systematic repositioning is crucial for effectively resolving the vertigo. While the Semont maneuver is another repositioning technique for BPPV, the Epley maneuver is more widely recognized and has been extensively studied for its efficacy in treating this condition. Surgical interventions are generally reserved for complicated cases of vertigo or when conservative measures have failed, making them less appropriate in the routine management of BPPV. The term "BPPV repositioning technique" is somewhat vague and could encompass various methods,