Assess Function / Vestibular Tests / Dix-Hallpike
Dix-Hallpike maneuver
- diagnostic clinical test for BPPV (all other physical exam findings are typically normal)
- negative test result may simply indicate that the displaced otoliths are not in a pathological position at that moment.
- test is performed by:
- rapidly moving the patient from a sitting position to the supine position with the head turned 45° to the right (moves one anterior/posterior canal into proper alignment)
- after waiting approximately 20-30 seconds, the patient is returned to the sitting position
- if no nystagmus is observed, the procedure is then repeated on the left side
- classic posterior canal BPPV produces geotropic rotatory nystagmus (the top pole of the eyes rotates toward the undermost, i.e., affected ear
- upbeating nystagmus indicates that the posterior canal is affected
- downbeating nystagmus indicates that the anterior canal is affected (more rare)