Hallpike Positional Test


This manoeuvre may be performed if you are suspected of having benign paroxysmal positional vertigo (BPPV). In this condition debris particles form in the balance canal fluids. A rapid downward movement of the head shakes up the debris rather like the commonplace Christmas snow models. As the particles sediment downwards under gravity they can stimulate some of the sensitive balance cells in the ampulla of the posterior semi-circular canal causing temporary vertigo and nystagmus, which occurs after a short delay. Induced dizziness during a downwards and/or upwards movement without nystagmus is not typical BPPV, but most likely due to a malfunctioning sensitive balance organ (labyrinth) and is a feature of an uncompensated peripheral vestibular disorder.


You will be positioned sitting on a bed, keeping your eyes open and looking straight ahead. Your head will be held firmly by the examiner’s hands and turned 45° to one side.

You will then be rapidly laid backwards with your head over the bed keeping your eyes fixed on the examiner’s nose. YOU WILL NOT BE ALLOWED TO FALL. You will be asked if this provokes your symptoms. If nothing happens within 30-60 seconds you will be returned to the upright position and asked if this has now provoked your symptoms. This process may be repeated on the other side. Sometimes the test is carried out using VNG goggles to obtain a digital computer record of the induced nystagmus.

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