Oct 27, The Dix-Hallpike maneuver is a powerful tool in the physician patients can be given instructions on how to do this at home for recurrences. If the Dix-Hallpike test is abnormal and the findings are “classic” for BPPV, then additional testing is not necessary. If the results are normal or not “classic” then. Introduction. The Hallpike test (also known as the DixHallpike test or manoeuvre) was developed and introduced into clinical practice in (Dix and. Hal/pike.

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Light-headedness or a sensation of nausea might last longer than one minute, but if the sensation of movement persists for more than one-minute alternative diagnoses must be considered.

Trick of the Trade: Dix-Hallpike maneuver

Approach to Evaluation and Management. Frenzel goggles can be useful to magnify the movements of the eyes. Vertigo can be a challenging complaint to evaluate and treat. From Wikipedia, the free encyclopedia. Non-paroxysmal vertigo is more likely to be caused by a vestibular syndrome or central etiology, such as brain stem stroke. Medical tests relating to hearing and balance R30—R39 The patient begins sitting up, and their head is oriented 45 degrees toward the ear to be tested.

Contraindications The Dix-Hallpike maneuver should be avoided in a patient with neck pathology, in whom the movements involved could be dangerous to the patient.

This page was last edited on 11 Decemberat Both the Dix—Hallpike and the side-lying testing position have yielded similar results. For some patients, this maneuver may not be indicated and a modification may be needed that also targets the posterior semicircular canal.


While there is a high rate of recurrence and this is not always effective, relieving the symptoms of our patients in this way is highly desirable, and patients can be given instructions on how to do this at home for recurrences.

The clinician then watches the patient’s eyes for torsional and up-beating nystagmus, which should start after a brief delay and persist for no more than one minute. The test may need to be performed more than once as it is not always easy to hallpiek observable nystagmus that is typical of BPPV.

Dix–Hallpike test

Rate and predictors of serious neurologic causes of dizziness in the emergency department. A mat table can be useful for elevating the shoulders and keeping the patient closer to the ground and thus, safer. All that is required for this test is a bed that can recline to horizontal, but certain equipment can be helpful, if available.

Affilations 1 Temple University Hospital. The clinician then lies the patient down quickly with their head past the end of the bed and extends their neck 20 degrees below the horizontal, maintaining maneuvef initial rotation of the head. Talmud 1 ; Scott C. Introduction Vertigo can be a challenging complaint to evaluate and treat.

Dix–Hallpike test – Wikipedia

The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Consider an antiemetic before implementing the test. Talmud ; Scott C. Typically, after a five to second delay, this will cause vertigo and rotary or up-beating nystagmus, which will resolve within 60 seconds.


It can arise from a slew of vastly different halplike, with acuity ranging from minimally consequential to catastrophic. Zhonghua Nei Ke Za Zhi.

Instrucions patients without an absolute contraindication, one paper suggests briefly assessing neck rotation and extension before attempting the maneuver to see if these positions can be comfortably maintained for thirty seconds. The exclusion of dangerous etiologies of vertigo should be the clinician’s primary concern, requiring excellent history and physical examination skills.

Dix—Hallpike test Unterberger test Romberg’s test Vestibulo—ocular reflex. In these circumstances the side-lying test or other alternative tests may be used. Technique The patient begins sitting up, and their head is oriented 45 degrees toward the ear to be tested.

Some ahllpike with a history of BPPV will not have a positive test result.

Similar articles in PubMed. Due to the position of the subject and the examiner, nystagmusif present, can be observed directly by the examiner. Author Information Authors Jonathan D. In rare cases a patient may be unable or unwilling to participate in the Dix—Hallpike test due to physical limitations.