The loaded Dix-Hallpike test for BPPV

Does a slight change to the Dix-Hallpike maneuver yield better test results?

Benign paroxysmal positional vertigo (BPPV) is a common form of dizziness. The physiology of BPPV is when otoconia (often referred to as ‘crystals’ or free floating particles in the semicircular canal) influence the vestibular neurological signal to the brain when the head moves. The Dix-Hallpike test is a common test for assessing the posterior canal to see if BPPV is present.

Previous studies have suggested that a poor testing result may be due to the positioning of the otoconia in the canal prior to the full testing procedure. The authors of this article investigated whether a ‘loaded’ head positioning prior to testing would produce a greater duration and/ or more intense nystagmus response so that the assessor can establish a positive test easier.


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