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What is the best next step in treatment for a patient experiencing sudden onset vertigo after sitting up from a supine position?

  1. Dix-Hallpike maneuver

  2. Epley maneuver

  3. Prednisone

  4. Salt-restricted diet

The correct answer is: Epley maneuver

In diagnosing and managing sudden onset vertigo, particularly when it occurs after an action such as sitting up from a supine position, it's critical to consider the underlying cause, which often points to benign paroxysmal positional vertigo (BPPV). The Epley maneuver is a therapeutic maneuver specifically designed to reposition displaced otoliths in the semicircular canals, which are responsible for the sensation of vertigo in BPPV. When a patient presents with symptoms of vertigo triggered by changes in head position, such as sitting up or lying down, it typically indicates BPPV rather than a central neurological cause. The Epley maneuver effectively helps alleviate symptoms by guiding these otoliths back to their proper locations, thus resolving the vertigo. While other options like the Dix-Hallpike maneuver are utilized for diagnosis, they do not provide treatment. Prednisone is employed in cases of inflammatory inner ear disorders, which would not apply here without additional context or symptoms. A salt-restricted diet is relevant primarily in conditions like Meniere's disease and doesn't address the immediate vertigo from a positional standpoint. Therefore, utilizing the Epley maneuver is the most appropriate next step in addressing the patient's vertiginous symptoms by directly targeting