Physical Exam

Dix-Hallpike Maneuver

🎬

Video coming September 2026

How to Perform

Seat the patient lengthwise on the table so that, when lowered, the head will extend just beyond the end. Turn the patient’s head about 45° toward the side being tested and support the head while quickly lowering the patient into a supine position with the neck extended so the head hangs about 20° below horizontal. Keep the head turned and hold this position for at least 30 seconds while watching the eyes. Ask the patient to keep their eyes open and report any vertigo. Return the patient to sitting, then test the other side. A positive test is provoked vertigo with upbeating, torsional nystagmus toward the lower ear that begins after a brief latency, builds, and then subsides.

How to Interpret

This test’s findings are all below your current evidence filter.

References

Halker RB, Barrs DM, Wellik KE, Wingerchuk DM, Demaerschalk BM. Establishing a diagnosis of benign paroxysmal positional vertigo through the Dix-Hallpike and side-lying maneuvers: a critically appraised topic. Neurologist. 2008 May;14(3):201-204. PMID 18469678.
Dix MR, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med. 1952;45(6):341-354.

Research last updated September 9, 2026.