This page includes the following topics and synonyms: Dix-Hallpike Maneuver. RECOMMENDED PROCEDURE FOR HALLPIKE MANOEUVRE. 1. Introduction. The Hallpike test (also known as the DixHallpike test or manoeuvre) was. Contraindications for the Hallpike-Dix test and Epley maneuver include vertebral artery stenosis, cervical spine dysfunction, or osteoporosis. •. Recommend.

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Definition Indication Contraindications Procedure Interpretation: Both the Dix—Hallpike and the side-lying testing position have yielded similar results. 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.

Search other sites for ‘Dix-Hallpike Maneuver’. Some patients with a history of BPPV will not have a positive test result. 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.

To access free multiple choice questions on this hallpioe, click here. Each of the three canals is oriented slightly differently, with the anterior and posterior canals in the vertical plane, set to detect movement in the sagittal and coronal planes, respectively, and the lateral canal 30 degrees off from the horizontal plane, detecting movement maneuvdr the left or right in the horizontal plane.

Dix Hallpike Maneuver Jonathan D. 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. Number of maneuvers need to get a negative Dix-Hallpike test. Vertigo and dizziness in the emergency department.

Dix-Hallpike Maneuver

PMC ] [ PubMed: A positive test is indicated by patient report of a reproduction of vertigo and clinician observation of nystagmus involuntary eye movement. This results in the sensation of movement and nystagmus characteristic of vertigo in brief paroxysms with positional changes of the head. This page was last edited on 11 Decemberat It can arise from a slew of vastly different pathophysiologies, with acuity ranging from minimally consequential to catastrophic.


During normal rotational hallpikf of the head, the fluid hsllpike remains relatively motionless while the canals and the hair cells move.

Dix–Hallpike test

Dix—Hallpike test Unterberger test Romberg’s test Vestibulo—ocular reflex. Clear Turn Off Turn Ahllpike. The exclusion of dangerous etiologies of vertigo should be the clinician’s primary concern, requiring excellent history and physical examination skills.

Author Information Authors Jonathan D. This disease process is thought to be caused by free-floating debris often in the form of a calcium carbonate stones, termed otoliths in the semicircular canals of the inner ear.

A Critically Appraised Topic”. Contraindications Elderly with significant carotid vascular disease. The 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 second delay, this will cause vertigo and rotary or up-beating nystagmus, which will resolve within 60 seconds.

This would indicate a positive test. Epub Apr Video ENG equipment can be used by advanced practitioners to better monitor hsllpike movements during this maneuver. Technique The patient begins sitting up, and their head is oriented 45 degrees toward the ear to be tested.

Support Center Support Center. Although there are alternative methods to administering the test, Cohen proposes advantages to the classic maneuver. Show details Treasure Island FL: The head is rotated 45 degrees away from the side being tested, and the eyes are examined for nystagmus.


In rare cases a patient may be unable or unwilling to participate in the Dix—Hallpike test due to physical limitations. Otolaryngol Head Neck Surg. Otolaryngology – Examination Pages.

Dix Hallpike Maneuver – StatPearls – NCBI Bookshelf

For some patients, this maneuver may not be indicated and a modification may be needed that also targets the posterior semicircular canal. Retrieved from ” https: Approach to Evaluation and Management. A subject must have adequate cervical spine range of motion to allow neck extension, as well as trunk and hip range of motion to lie supine.

Talmud ; Scott C. Related Topics in Examination. If the test is negative but clinical suspicion remains high, the patient should be given a chance to recover for at least one minute, and then testing of the other ear can be undertaken. Positive signs suggestive of Paroxysmal Positional Vertigo Vertigo Rotary Nystagmus Globe torques around central axis Counterclockwise or clockwise Latent period follows procedure before Nystagmus Response Fatigue s or habituates on repetition. International Journal of Audiology.

The test can be easily administered by a single examiner, which prevents the need for external aid. Hearing test Rinne test Tone decay test Weber test Audiometry pure tone visual reinforcement.

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The test may need to be performed more than once as it is not always easy to demonstrate observable nystagmus that is typical of BPPV.