Hallpike positioning test

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Hallpike Manoeuvre (sometimes Dix-Hallpike) is a test for benign paroxysmal positional vertigo

  1. Sit patient on examination couch and explain procedure. Explain that it will make them feel dizzy and that they will not be allowed to fall. The head should be turned 45 degress to one side before the lying down movement is commenced.
  2. Lie patient supine with their head over the end of the examination bed, supported in 30° flexion by the operator with a hand on each side of head. The 45 degree head turn is maintained.
  3. Inspect the eyes for nystagmus, and ask if they feel dizzy, although this will usually be obvious. Hold this position for at least 30 seconds, and for a minute if there is no reponse.
  4. A positive result includes symptoms and nystagmus. There is usually a latent period of five seconds before the onset of nystagmus, which fatigues rapidly. The fast phase of the nystagmus is directed towards the undermost ear.
  5. Repeat on the right side.

External link

British Association of Audiological Physicians diagnostic worksheet for BPPV (2004)

 The aim is swing the debris in the posterior canal around the curve of the canal.
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