Dix-Hallpike test


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Dix-Hallpike test

[hôl′pīk]
a method for evaluating the function of the vestibule of the ear in patients with vertigo or hearing loss. The patient's position is quickly changed from sitting to lying down with the neck hyperextended, and then returned to sitting. Nystagmus can then be evaluated, and specific disorders of the vestibule may be diagnosed. See also caloric test, electronystagmography, nystagmus.
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A primary diagnosis of BPPV was made due to the positioning nature of PB's 'wobble' symptoms, the brief latency of these symptoms and the positive Dix-Hallpike test demonstrating a positional upbeat clockwise torsional nystagmus.
The criterion for a vestibular anomaly is either an abnormal result on the Dix-Hallpike test or an abnormal result on at least two of the other three tests (rotational chair test, posturography, or ENG/VNG).
The presence of a burst of rotary nystagmus, which is counterclockwise at the right side and clockwise at the left side in the Dix-Hallpike test and subsides within seconds, indicated a typical posterior semicircular canal BPPV.
Five months following her first visit, a Dix-Hallpike test revealed that nystagmus occurred only when her head was down and to the left.
Positional vertigo and nystagmus demonstrated on the Dix-Hallpike test that does not fit the characteristics of BPPV raises the suspicion of other diseases.
However, the results of her positional testing were abnormal, as the Dix-Hallpike test provoked a marked rotary nystagmus bilaterally.
Repeated Dix-Hallpike tests were positive for left sided posterior semicircular canal BPPV despite multiple particle repositioning procedures over a period of three years.