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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Technique The patient begins sitting up, and their head is oriented 45 degrees toward the ear to be tested. Introduction Vertigo can be a challenging complaint to evaluate and treat.

Although there are alternative methods to administering the test, Cohen proposes advantages to the classic maneuver. The exclusion of dangerous etiologies of vertigo should be the clinician’s primary concern, requiring excellent history and physical examination skills.

Approach to Evaluation and Management. Show details Treasure Island FL: These patients experience vertigo in brief episodes lasting less than one minute with changes of head position and return to total normalcy between episodes. Started inthis collection now contains interlinked jallpike pages divided into a tree of 31 specialty books and chapters. A positive test is indicated by patient report of a reproduction manekver vertigo and clinician observation of nystagmus involuntary eye movement.

Affilations 1 Temple University Hospital. From the previous point, the use of this maneuver can be limited by musculoskeletal and obesity issues in a subject. Otolaryngol Head Neck Surg. The test results can also be affected by the speed the maneuver is manever in and the plane the occiput is in.

Number of maneuvers need to get a negative Dix-Hallpike test.

Dix–Hallpike test – Wikipedia

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 to the left or right in the horizontal plane.


There are several disadvantages proposed by Cohen for the classic maneuver. This would indicate a positive test.

Content is manehver monthly with systematic literature reviews and conferences. 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.

Dix–Hallpike test

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. 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 ,aneuver comfortably be in a supine position. The head is rotated 45 degrees away from the side being tested, and the eyes are examined for nystagmus.

Dix Hallpike Maneuver Jonathan D.

The hair cells hallpik mechanically pushed by the resistance of hallpike endolymph, opening mechanically gated ion channels that trigger an action potential indicating rotational movement. 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.

Procedure Patient starts in sitting position on exam table Facing forward with eyes open Rapidly lie patient backward Head turned 45 degrees to RIGHT Neck extended 20 degrees hanging over end of table Patient remains in this position for 30 seconds Sit patient up Rapidly lie patient backward Head turned 45 degrees to LEFT Neck extended 20 degrees hanging over end of table Patient remains in halpike position for 30 seconds Observe Nystagmus Vertiginous symptoms.


Review Benign paroxysmal positional vertigo. Search Bing for all related images.

Dix-Hallpike Maneuver

This hallpke was last edited on 11 Decemberat The maneuver, when properly employed, can identify a common, benign cause of vertigo, which can then be treated with bedside maneuvers, often providing instant relief to patients. In rare cases a patient may be unable or unwilling to participate in the Dix—Hallpike test due to physical limitations. N Engl J Med. Consider an antiemetic before implementing the test.

Zhonghua Nei Ke Za Zhi. This book is distributed under the terms of the Creative Commons Attribution 4. From Wikipedia, the free encyclopedia. Patients may be too tense, for fear of producing vertigo symptoms, which mmaneuver prevent the necessary brisk passive movements for the test. Personnel This test can be accomplished by a single practitioner. In these circumstances the side-lying test or other alternative tests may be used.

Dizziness is a common complaint, and serious causes must be considered and excluded first. Hearing test Rinne test Tone decay test Weber test Audiometry pure tone visual reinforcement. By using this site, you agree to the Terms of Use and Privacy Policy.

Vertigo can be a challenging complaint to evaluate and treat. 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.