Dix–Hallpike maneuver

Dix–Hallpike maneuver is used to identify

A. Diplopia


C. Vertebrobasilar insufficiency

D. Sensory neural deafness

Which of the following is also called as ‘Repositioning maneuver’?

A. Dix–Hallpike maneuver

B. Epley maneuver

C. Valsalva maneuver

D. Heimlich maneuver

Gold standard for diagnosing benign positional paroxysmal vertigo

Dix-Hallpike maneuver is the gold standard for diagnosing benign positional paroxysmal vertigo caused by a posterior canal otolith.

Most common canal affected in benign positional paroxysmal vertigo

The posterior canal is affected 90% of the time in benign positional paroxysmal vertigo, and lateral canal pathology causes approximately 8% of cases.

Dix–Hallpike maneuver

Patient is positioned recumbent with the head back and toward the affected ear, causing the otolith to progress superiorly along the natural course of the canal. Typically, after a five to 20-second delay, this will cause vertigo and rotary or up-beating nystagmus, which will resolve within 60 seconds

Frenzel goggles

Frenzel goggles – useful to magnify the movements of the eyes.

Positive test

Patient begins sitting up, and their head is oriented 45 degrees toward the ear to be tested.

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 the initial rotation of the head.

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.

This would indicate a positive test.

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