This page includes the following topics and synonyms: Dix-Hallpike Maneuver. Dix Hallpike Test. • Stand to the side of the patient. • Pt sitting with head turned to examiner. • Pt sat so that when supine, the head will be beyond the end of. The Dix-Hallpike test, also called the “Hallpike” is the definitive diagnostic test If the person has arthritis in their neck, the maneuver may be.

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The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system.

All that is required for this test is a bed that can recline to horizontal, but certain equipment can be helpful, if available. Cervical instability, vascular problems like vertebrobasilar insufficiency and carotid sinus syncope, acute neck trauma and cervical disc prolapse are absolute contraindications. Once supine, the eyes are typically observed for about 30 seconds. Typically, after a five to second delay, this will cause vertigo and rotary or up-beating nystagmus, which will resolve within 60 seconds.

International Journal of Audiology.

The exclusion of dangerous etiologies of vertigo should be the clinician’s primary concern, requiring excellent history and physical examination skills. 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. Affilations 1 Temple University Hospital. Horizontal top and vertical bottom eye position during a Dix-Hallpike Test.

Show details Treasure Island FL: Otolaryngol Head Neck Surg.

Balance Tests – Dix-Hallpike – Epley Manoeuvre – TeachMeSurgery

Similar articles in PubMed. These images are a random sampling from a Bing search on the term “Dix-Hallpike Maneuver. A positive Dix-Hallpike tests consists of a burst of nystagmus jumping of the eyes.


Medical tests relating to hearing and balance R30—R39 Zhonghua Nei Ke Za Zhi. A person is brought from sitting to a supine position, with the head turned 45 degrees to one side and extended about 20 degrees backward. Both the Dix—Hallpike and the side-lying testing position have yielded similar results.

Dix–Hallpike test – Wikipedia

Patients may be too tense, for fear of producing vertigo symptoms, which can prevent the necessary brisk passive movements for the test. Epub Apr Frenzel Goggles used to visualize the eyes during the Dix-Hallpike test. If no nystagmus ensues, the person is brought back to sitting. Hain, MD Page last modified: A mat table big blue thing is very helpful in doing the Dix-Hallpike Test.

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.

This would indicate a positive test. Other types are d escribed here. Number of maneuvers need to get a negative Dix-Hallpike test.


Personnel This test can be accomplished by a single practitioner. There is a delay of about 30 seconds again, and then the other side is tested. A mat maneuvet can be useful for elevating the shoulders and keeping maneuvee patient closer to the ground and thus, safer. When performing the Dix—Hallpike test, patients are lowered quickly to a supine position lying horizontally with the face and torso facing up with the neck extended 30 degrees below vertical by the clinician performing the maneuver.

This enables the treating clinician to quantify response, and also is very helpful in situations where good documentation is essential such as in medicolegal cases.

Dix Hallpike & Epley Manoeuvres

Video ENG equipment can be used by advanced practitioners to better monitor eye movements during this maneuver. Due to the position of the subject and the examiner, nystagmusif present, can be observed directly by the examiner.


Such patients include those who are too anxious about eliciting the uncomfortable symptoms of vertigo, and those who may not have the range of motion necessary to comfortably be in a supine position. Others are described here. Talmud 1 ; Scott C.

Related Topics in Examination. This results in the sensation of movement and nystagmus characteristic of vertigo in brief paroxysms with positional changes of the head. The modification involves nallpike patient moving from a seated position to side-lying without their head extending off the examination table, such as with Dix—Hallpike.

Three canals make up this system, each forming a loop filled with endolymph and lined with hair cells.

The hair cells are mechanically pushed by the resistance of the endolymph, opening mechanically gated ion channels that trigger an action potential indicating rotational movement. Equipment All that is required for this test is a bed that can recline to horizontal, but certain hallpoke can be helpful, if available.

Dizziness is a common complaint, and serious causes must be considered and excluded first.

One of these is illustrated below in the mat-table illustration. By using this site, you agree to the Terms of Use and Privacy Policy. Related links to external sites from Bing.

This book is distributed under the terms of the Creative Commons Attribution 4.

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