Physical Exam

Dix-Hallpike Maneuver

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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. Supporting the head, lower the patient quickly into a supine position with the neck extended so the head hangs about 20° below horizontal, and keep the head turned 45°. Hold this position and watch the eyes for at least 30 seconds, asking the patient to keep their eyes open and to report any vertigo; then return them to sitting. Test each side separately. A positive test is provoked vertigo with a burst of nystagmus that begins after a brief latency, builds and then subsides, and fatigues on repetition.

How to Interpret

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

References

No qualifying diagnostic-accuracy anchor. 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 — this is a critically appraised topic (a compiled/secondary synthesis), a disallowed anchor type, retained here only to document why it cannot anchor a tier.
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.