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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Patients should address specific medical concerns with their physicians. National Center for Biotechnology InformationU. In rare cases a patient may be unable or unwilling to participate in the Dix—Hallpike test due to physical limitations. This results in the sensation of movement and nystagmus characteristic of uallpike in brief paroxysms with positional changes of the head.

Dix–Hallpike test – Wikipedia

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 patient begins sitting up, and their head is oriented 45 degrees toward the ear to be tested. Approach to Evaluation and Management. Please review our privacy policy. Positive signs suggestive of Paroxysmal Positional Vertigo Vertigo Rotary Nystagmus Maneuvdr torques around central axis Counterclockwise or clockwise Latent period follows procedure before Nystagmus Response Fatigue s or habituates on repetition.


These patients experience vertigo in brief episodes lasting less than one minute with changes of head position and return to total normalcy between episodes.

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.

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Vertigo can be a challenging complaint to evaluate and treat. Started inthis collection now contains interlinked topic pages divided into a tree of 31 specialty books and chapters.

Personnel This test can be accomplished by a single practitioner. The modification involves the patient moving from a seated position to side-lying without their head extending off the examination table, such as with Dix—Hallpike.

Views Read Edit View history. Otolaryngology – Examination Pages. StatPearls Publishing; Jan. In 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.

Dix–Hallpike test

A Critically Appraised Topic”. Dix—Hallpike test Unterberger test Romberg’s test Vestibulo—ocular reflex.

For some patients, this maneuver may not be indicated and a modification may be needed that also targets the posterior semicircular canal. 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 manekver the other ear can be undertaken.


Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal positional vertigo. There are several disadvantages proposed by Cohen for the classic maneuver.

In these circumstances the side-lying test or other alternative tests may be used. Patients may be too tense, for fear of producing vertigo symptoms, which can prevent the necessary brisk passive movements for the test. Related links to external sites from Bing.

Dix-Hallpike Maneuver

Questions To access free multiple choice questions on this topic, click here. Similar articles in PubMed. Typically, after a five to second delay, this will cause vertigo and rotary or up-beating nystagmus, which will resolve within 60 seconds. Dizziness is a common complaint, and serious causes must be considered and excluded first.

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

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N Engl J Med. To access free multiple choice questions on this topic, click here. Related Bing Images Extra: Author Information Authors Jonathan D. Retrieved from ” https: