Quick definition
The Dix-Hallpike test is a bedside maneuver used to diagnose posterior canal BPPV — the most common form of positional vertigo. The patient is sat up, head turned 45 degrees toward the side being tested, then rapidly laid back with the head extended below the level of the table. The clinician watches the eyes for nystagmus.
Medical definition
A positive Dix-Hallpike for posterior canal BPPV produces a torsional and up-beating nystagmus that begins after a 1 to 5-second latency, peaks within 10 seconds, lasts under a minute, and fatigues on repeat testing. Both sides should be tested. A negative Dix-Hallpike does not rule out BPPV — it can miss lateral and anterior canal variants, which need the supine roll test instead.
Why it matters in vertigo and balance disorders
The Dix-Hallpike is the single most useful test in a vertigo clinic. It tells me whether BPPV is the diagnosis, which side is affected, and which canal — information that determines the exact repositioning maneuver to perform. Without it, even a confident diagnosis of BPPV is guesswork.
Where I see this in clinic
I run a Dix-Hallpike on almost every new vertigo patient. With the videonystagmography (VNG) goggles we have at Prime ENT Center, the eye movements are recorded objectively, which is invaluable for cases that are atypical or recurrent. Patients are warned that the test will trigger their vertigo briefly — that is, in fact, the point of the test.
Related terms
Part of: Vestibular and ENT Glossary — A to Z of vestibular, balance, and ENT terms by Dr. Prateek Porwal.
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