Dix-Hallpike Maneuver

The Dix-Hallpike Maneuver is a maneuver designed to help identify vertigo in patients. Specifically, it can help to diagnose a paroxysmal positional vertigo or BPPV – a disorder that affects the inner ear and causes spinning sensations during changes in head position.

If you find yourself experiencing regular dizziness, then you can ask a friend to read the following instructions to try and help you identify whether this might be the case. However, it is advisable that you do not attempt this without the help of a trained medical professional.

The Dix-Hallpike Maneuver

To begin with, ask the patient to sit down on a bench or table with their arms crossed. Turn their head 45 degrees and hold eye contact for about 30 seconds. Then lower them backwards quickly but smoothly so that they are lying down with their head extended about 20 degrees over the back of the surface. If the patient does suffer with benign paroxysmal positional vertigo, then you’ll be able to see their nystagmus about 20 seconds afterward. It’s a good idea to then hold their head back in the upright position for around a minute to help them readjust. This can be quite a traumatic experience for the patient. Make sure that they know it is very important for them to keep their eyes open. Perform the Dix-Hallpike maneuver on both sides.

Nystagmus is a continuous uncontrolled movement of the eyes which will cause changes in the size of the pupil as well. If this is seen during the Dix-Hallpike maneuver then this may help to confirm a diagnosis of BPPV and thus inform the best course of treatment.

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