Diagnosis was made primarily through history and by eliciting typical physical findings during Dix Hallpike maneuver. Pure Tone Audiometry (PTA) was normal in all the patients except for age related decreased hearing.
(4) Diagnosis is mainly by history and Dix Hallpike maneuver. Treatment is mainly supportive and Canalith repositioning maneuver (CRP) with or without vestibular sedatives.
The diagnosis is based on findings of typical positional rotatory nystagmus provoked by the head-hanging position (Hallpike maneuver) [2] and the observation of certain characteristic features, including a brief latency (usually 1 to 5 sec), limited duration (usually [greater than]30 sec), reversal on assuming an upright position, and a fatiguing of the response on repeat testing.
An absolute requirement for inclusion in this study was a positive nystagmus response to the Hallpike maneuver. Patients underwent a complete bedside vestibular test--including an oculomotor test, a positional and positioning test, a Romberg's test, and a tandem gait test--and most of them underwent audiography and electronystagmography.
The physician guided the patient backward into the provocative position (the Hallpike maneuver) with the diseased ear down.
During followup visits, patients were evaluated subjectively by self-reports of symptom status and objectively by their response to the Hallpike maneuver. They were also asked if they experienced any after-effects of therapy.