anterior canalithiasis, benign paroxysmal positional vertigo, BPPV, Dix-Hallpike Maneuver, downbeating nystagmus, neuro test, nystagmus, posterior canalithiasis, upbeating, vertigo, vestibular test

Purpose

A test used to identify benign paroxysmal positional vertigo (BPPV). This test also identifies the type and location of BPPV in patients with BPPV.

Technique

Patient is positioned in long sitting on a table or plinth.

Clinician stands facing the patient and instructs patient to cross her arms in front of her chest.

Clinician rotates the patient’s head 45° then extends it about 30° toward the testing side.

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

Clinician rapidly brings the patient down to supine with the patient’s head extended over the edge of the table.

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

Clinician holds the patient in this position for 30-60 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 on the side the head is rotated to.

The production of downbeating nystagmus indicates anterior canalithiasis contralateral to 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 with Assistance
2. BPPV – Side-lying Test
3. BPPV – Roll Test
4. Vertebral Artery Test
5. Spurling’s Test