Vertigo: assessments
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Vertigo: assessments. This tests for benign paroxysmal positional vertigo (BPPV). Fully referenced neurology checklist.
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
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Hennebert’s test
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Nystagmus suppression
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Other assessments
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Investigations and treatments
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References
- Sura DS, Newell S. Vertigo-diagnosis and management in primary care. BJMP 2010; 3:a351.
- Viirre E, Purcell I, Baloh RW. The Dix-Hallpike test and the canalith repositioning maneuver. Laryngoscope 2005; 115:184-187.
- Labuguen RH. Initial evaluation of vertigo. Am Fam Physician 2006; 73:244-251.
- Seemungal BM, Bronstein AM. A practical approach to acute vertigo. Pract Neurol 2008; 8:211-221.
- McDowell T, Moore F. The under-utilization of the head impulse test in the emergency department. Can J Neurol Sci 2016; 43:398-401.
