Applicability of the Dix-Hallpike test on benign paroxysmal positional vertigo: literature review / Aplicabilidade do teste de Dix-Hallpike sobre vertigem posicional paroxística benigna: revisão de literatura

Objective; to analyze the applicability of the Dix-Hallpike maneuver on BPPV as a diagnostic method for the semicircular canals as well as its sensitivity. Methods: a literature review was performed using the following sourcing databases: LILACS, PubMed, SCIELO looking forpapers published in Portuguese, English and Spanish. The following searching strategy descriptors were used: vertigo, vestibular diseases and respiratory therapy techniques, being included publications between the years 2000 and 2017. Results: the results of the work were presented through a synoptic table and flowchart. Conclusion: There is still controversy regarding its sensitivity to the anterior and lateral canals, even if the maneuver, does not present sensitivity of 100%, its level of closeness provides security in the diagnosis of BPPV.

Objetivo: Analisar a aplicabilidade da manobra de Dix-Hallpike sobre a VPPB como método diagnóstico para os canais semicirculares, bem como sua sensibilidade. Métodos: realizou-se revisão bibliográfica utilizando as seguintes bases de dados de sourcing: LILACS, PubMed, SCIELO procurando por artigos publicados em português, inglês e espanhol. Foram utilizados os seguintes descritores da estratégia de busca: vertigem, vestibulopatias e técnicas de fisioterapia respiratória, sendo incluídas publicações entre os anos de 2000 e 2017. Resultados: os resultados do trabalho foram apresentados por meio de tabela e fluxograma sinóptico. Conclusão: Ainda há controvérsias quanto à sua sensibilidade aos canais anteriores e laterais, mesmo que a manobra, não apresente sensibilidade de 100%, seu grau de proximidade proporciona segurança no diagnóstico da VPPB.

Management of bilateral benign paroxysmal positional vertigo with Dix-Hallpike test / 中华内科杂志

Objective To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) with bilateral positive Dix-Hallpike test.Methods This is a retrospective study based on the clinical data of BPPV patients diagnosed in the Dizziness Clinic of Changzheng Hospital from January 2012 to December 2012.Totally 490 patients with vertigo and nystagmus provoked by Dix-Hallpike maneuver were included in the present analysis.Results Among all the patients,55 (11.2％) of them presented with bilateral nystagmus by the provocative test.According to the type of nystagmus provoked by DixHallpike maneuver,the 55 patients can be divided into the following four categories.(1) Bilateral geotropic (n =16) and apogeotropic nystagmus (n =5):all these patients were diagnosed with horizontal canal BPPV and free of vertigo after head side-shaking exercise in supine position and Barbecue maneuver.(2) Bilateral predominant down-beating nystagmus (n =2):patients in this group were diagnosed with anterior canal BPPV,and got recovered after Kim maneuver.(3) Bilateral torsional up-beating geotropic nystagmus (n =20):after a lying-down test,6 of the patients manifested as vertical up-beating nystagmus and 14 patientsremained torsional up-beating nystagmus.The formerwere diagnosed with bilateral posterior canal BPPV,and were cured after bilateral PRM therapy,and the latter were diagnosed with horizontal canal BPPV,who were cured after Barbecue maneuver.(4) Torsional up-beating geotropic nystagmus on one side and down-beating nystagmus on the other side (n =12).The down-beating nystagrnus on the other side disappeared when the patients was firstly seated up with head down in 30 degrees for half an hour before second Dix-Hallpike maneuver.These patients were diagnosed with unilateral posterior canal BPPV and cured by PRM therapy.Conclusions It is common for vertigo patients with bilateral nystagmus induced by Dix-Hallpike test.The diagnoses should be made by the types of nystagmus provoked step by step before maneuver therapy.

An Atypical Case of Benign Paroxysmal Positional Vertigo of the Anterior Semicircular Canal / 대한평형의학회지

Benign paroxysmal positional vertigo (BPPV) of anterior semicircular canal (ASC) is the rarest variant of BPPV, which is thought to be due to the anatomically superior position of ASC during most activities. This type of BPPV is currently diagnosed by detecting positional down-beating nystagmus in the Dix-Hallpike test. A 62-year-old female presented with positional vertigo, especially when sitting up. No nystagmus was induced by both Dix-Hallpike tests, however, positional down-beating nystagmus was observed with the left torsional component when sitting up from both Dix-Hallpike positions and supine position. After the reverse Epley maneuver, up-beating nystagmus was newly observed in the left Dix-Hallpike test, which was compatible with BPPV of the left posterior semicircular canal. This patient was thought to suffer from canalithiasis of the left ASC.