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The HINTS Exam - Differentiating Central vs Peripheral Vertigo

Head Impulse Test
Nystagmus
Test of Skew

Animation by Dr. Y.
The HINTS Exam - ... Differentiating Central vs ... Head Impulse Test ... Nystagmus Test ... JayLin3455 #HINTS
Differentiating Benign Paroxysmal Positional Vertigo (BPPV) From Vestibular Neuritis-Labyrinthitis
BENIGN PAROXYSMAL POSITIONAL VERTIGO
 • Age: More common
the head) • Hallpike ... and torsional nystagmus ... ) • Epley maneuver ... : Constant • Hallpike ... seen) • Epley maneuver
The head impulse test (HIT) result is positive (abnormal) in nearly all patients with a peripheral
The head impulse test ... a stand-alone test ... patients with an AVS ... with nystagmus. ... #Testing #HIT #HINTS
Dix-Hallpike Maneuver for BPPV

Procedure:
1. Make the patient sit on examination table, such that the shoulders would
Dix-Hallpike Maneuver ... 45° towards the test ... throughout the test ... patient’s head as ... affected ear #Dix #Hallpike
Dix-Hallpike Maneuver for the Diagnosis of BPPV (Animated)

The Dix–Hallpike test (Nylen Barany test) is a diagnostic
Dix-Hallpike Maneuver ... Animated) The Dix–Hallpike ... test (Nylen Barany ... test) is a diagnostic ... maneuver used to
Dix-Hallpike Maneuver for the Diagnosis of BPPV
The Dix–Hallpike test (Nylen Barany test) is a diagnostic maneuver
Dix-Hallpike Maneuver ... of BPPV The Dix–Hallpike ... test (Nylen Barany ... test) is a diagnostic ... maneuver used to
Dix-HaIlpike Maneuver
 • Turn head to 45° and then rapidly lay patient to a supine position
Dix-HaIlpike Maneuver ... The test is positive ... is rotational nystagmus ... TylerLarsenMD #Dix #HaIlpike ... #Maneuver #neurology
Diagnostic Algorithm for Dizziness and Vertigo
Peripheral Vertigo:
 • Attacks: Sudden, severe, can last anywhere from seconds
minutes to days • Nystagmus ... vascular causes • Nystagmus ... Positive Hallpike ... test (posterior ... Vertigo #Algorithm #differential
Algorithm for the diagnostic evaluation of dizziness. (HINTS = head-impulse, nystagmus, test of skew.)
Questions regarding the
(HINTS = head-impulse ... , nystagmus, test ... the dizziness as ... Dizziness #Algorithm #Differential
Diagnostic algorithm for differentiating vestibular neuritis from stroke in patients with AVS. This sequence of testing
patients with AVS ... care physician; AVS ... , Nystagmus, and ... Test of Skew. ... #Diagnosis #AVS