Benign paroxysmal positional vertigo diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

The diagnostic study of choice for BPPV is patient history and observing nystagmus on Dix-Hall pike maneuver.

Diagnostic Study of Choice

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Study of choice

The diagnostic study of choice for BPPV is patient history and observing nystagmus on Dix-Hall pike maneuver.

Investigations:

• Among the patients who present with clinical signs of BPPV, the Dix-Hallpike maneuver is the most specific test for the diagnosis.

Diagnostic results

The following findings are confirmatory for BPPV:

• Recurrent brief vertigo attack which starts with certain head movements.
• Nystagmus on Dix-Hallpike maneuver.

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:

• Patient history
• Physical examination (Dix-Hall pike maneuver)

If patients doesn't respond to treatment or doesn't show the typical nystagmus on Dix-Hall pike maneuver, in order to rule out other abnormalities we may perform some additional test such as:

• Electronystagmography (ENG) or video nystagmography (VNG)
• Audiometry
• Neuroimaging

For more information about these tests, click here.

Name of Diagnostic Criteria

There are no established criteria for the diagnosis of BPPV.