What is the best course of treatment for a 65-year-old woman with episodic vertigo lasting 30-60 seconds after a head injury?

The best course of treatment involves canalith repositioning with Brandt-Danoff exercises because these interventions are specifically designed to address certain types of vertigo, particularly Benign Paroxysmal Positional Vertigo (BPPV), which is a common condition in older adults that can occur following a head injury.

Canalith repositioning maneuvers, such as the Epley maneuver, aim to move the dislodged otoconia (calcium carbonate crystals) back into the utricle, where they do not cause symptoms. Brandt-Danoff exercises are beneficial for helping the patient habituate to movements that trigger vertigo, thereby reducing episodes over time. This combination addresses both the immediate physical cause of the vertigo and helps in the retraining of the vestibular system, which can be very effective for long-term relief.

While motion sensitivity exercises can help a patient become more accustomed to the movements that elicit vertigo, they may not address the underlying problem as thoroughly as the combination of canalith repositioning and Brandt-Danoff exercises. Referring back to the physician immediately may be appropriate in some cases, especially if there are concerns about serious pathology, but for a patient specifically with episodic vertigo after