• Vertigo associated with a characteristic mixed torsional and vertical nystagmus provoked by the Dix-Hallpike test

• A latency (typically of 1 to 2 seconds) between the completion of the Dix-Hallpike test and the onset of vertigo and nystagmus

• Paroxysmal nature of the provoked vertigo and nystagmus (i.e., an increase and then a decline over a period of 10 to 20 seconds)

• Fatigability (i.e., a reduction in vertigo and nystagmus if the Dix-Hallpike test is repeated)

   

 

Common Causes of Vertigo

Otologic disorders

• Benign paroxysmal positional vertigo

• Meniere´s disease (hydrops endolymphayic)

• Vestibular neuronitis (labyrinthitis)

Neurologic disorders

• Migraine-associated dizziness

• Vertebrobasilar insufficiency

• Panic disorders

 

Dix-Hallpike Maneover for Positional Nystagmus

 

	Peripheral disorder	Central disorder
Latent period before onset of positional nystagmus	2 to 20 seconds	None
Duration of nystagmus	Less than 1 minute	Greater than 1 minute
Fatigability	Fatiguing with repetition	Nonfatiguing
Direction of nystagmus	Only one type, usually horizontal/rotatory	May change direction with a given head position
Intensity of vertigo	Severe	Less severe, sometimes none

 

 

 

 

 

 

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