Vertigo: assessments

Evidence-based neurology checklist on vertigo: assessments: Dix Hallpike manouevre This tests for benign paroxysmal positional vertigo (BPPV) The subject is moved rapidly backwards from a sitting position to a head-hanging position The head is kept tilted 30 to 45 degrees to the ipsilateral side…

Dix Hallpike manouevre

  • This tests for benign paroxysmal positional vertigo (BPPV)
  • The subject is moved rapidly backwards from a sitting position to a head-hanging position
  • The head is kept tilted 30 to 45 degrees to the ipsilateral side
  • The head is kept at least 10 degrees below the horizontal level
  • The eyes are kept open and looking at the examiner’s eyes
  • The test induces rotatory upbeat or horizontal nystagmus after a latent period of 2-20 seconds
  • The nystagmus changes direction on sitting back up

Halmagyi head impulse (head thrust) test

Hennebert’s test

Nystagmus suppression

Other assessments

Investigations and treatments

References

  1. Sura DS, Newell S. Vertigo-diagnosis and management in primary care. BJMP 2010; 3:a351.
  2. Viirre E, Purcell I, Baloh RW. The Dix-Hallpike test and the canalith repositioning maneuver. Laryngoscope 2005; 115:184-187.
  3. Labuguen RH. Initial evaluation of vertigo. Am Fam Physician 2006; 73:244-251.
  4. Seemungal BM, Bronstein AM. A practical approach to acute vertigo. Pract Neurol 2008; 8:211-221.
  5. McDowell T, Moore F. The under-utilization of the head impulse test in the emergency department. Can J Neurol Sci 2016; 43:398-401.

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