Dix-Hallpike Maneuver for the Diagnosis of BPPV (Animated) The Dix–Hallpike test (Nylen Barany test) is a diagnostic maneuver used to identify posterior BPPV. It consist of: 1) Rotate the patient's head 45 degrees. Some patient complain of the affected side, so, head should rotate to the affected side. But in undefined cases you should repeat this test bilaterally. 2) Lay down the patient in supine position while a pillow placed under the patient's shoulders. 3) While the patient's head rotated 45 degree and hanging down 30 degree, look for nystagmus. After a short latency, nystagmus starts and after a while, the nystagmus resolves (fatigability). Nystagmus has two component : vertical and torsional. In the vertical component, an upbeat nystagmus indicates posterior canaliths. But a downbeat nystagmus indicate anterior canaliths. After sitting upright, the nystagmus direction will be reversed. The side that nystagmus is more intense is the same affected side. #Dix #Hallpike #DixHallpike #Maneuver #Diagnosis #BPPV #neurology #Animated #PhysicalExam
