What is the role of the Dix-Hallpike test in the diagnosis of dizziness, vertigo, and imbalance?

Updated: Mar 13, 2017
  • Author: Hesham M Samy, MD, PhD; Chief Editor: Robert A Egan, MD  more...
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Answer

Positioning nystagmus is a classic finding in patients with benign paroxysmal positional vertigo (BPPV). It is elicited by moving the patient rapidly from the sitting position to the head-right-down and head-left-down positions while observing and recording resulting nystagmus and symptoms. Hyperextension of the neck is not necessary and should be avoided. Two ENG channels are required to determine the direction of the torsional component of the nystagmus.

ENG is less sensitive than clinical observation of benign positioning nystagmus because ENG is insensitive for recording torsional BPPV components. In the authors’ opinion, ENG is not useful in evaluating patients for BPPV nystagmus.


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