anterior canalithiasis, benign paroxysmal positional vertigo, BPPV, downbeating nystagmus, neuro test, nystagmus, posterior canalithiasis, side lying, Side lying test, upbeating, vertigo, vestibular test

Purpose

A test used to determine if the patient has benign paroxysmal positional vertigo (BPPV) and cannot tolerate a supine position.

Technique

Patient is positioned sitting with legs together and the Clinician stands facing the patient.
Clinician asks patient to cross her arms in front of her chest.

Clinician instructs the patient to keep her eyes open during the test.

Clinician places his hands on the patient’s zygomatic processes.

Clinician rotates the patient’s head 45° towards the opposite side of testing and then extends head about 30°.

Clinician rapidly brings the patient down into side lying while the Assistant brings the patient’s leg up onto the plinth.

Clinician observes the patient’s eye movements looking for nystagmus.

Clinician holds the patient in this position for 60 seconds.
Technique is repeated on the other side.

Positive

The production of nystagmus or other symptoms (vertigo, nausea, ect)

Interpretation

The presence of nystagmus or other symptoms indicates BPPV.

The production of upbeating nystagmus indicates posterior canalithiasis contralateral to the side the head is rotated to.

The production of downbeating nystagmus indicates anterior canalithiasis on the side the head is rotated to.

References

1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York, NY: The McGraw-Hill Companies, Inc.

Related videos:

1. BPPV – Side-lying Test
2. BPPV – Dix-Hallpike Maneuver
3. BPPV – Roll Test
4. Femoral Nerve Test (in side lying)
5. Vertebral Artery Test