The Journal of International Advanced Otology
Original Article

Optimizing Testing for BPPV – The Loaded Dix-Hallpike

1.

Department of Otolaryngology Head and Neck Surgery, Geisinger Medical Center, Pennsylvania, USA

2.

Department of Biomedical and Translational Informatics, Geisinger Medical Center, Pennsylvania, USA

J Int Adv Otol 2020; 16: 171-175
DOI: 10.5152/iao.2020.7444
Read: 58 Downloads: 8 Published: 28 July 2020

OBJECTIVES: Although the Dix-Hallpike testing is generally considered as the gold standard for the identification of the posterior canal benign paroxysmal positional vertigo (BPPV), we investigated a modification of the maneuver termed the “loaded Dix-Hallpike.” Study Design: Prospective randomized controlled trial.

MATERIALS and METHODS: Twenty-eight patients participated in this prospective study comparing the standard Dix-Hallpike (S-DH) to the loaded Dix-Hallpike (L-DH) test. Each patient underwent repeated testing with the S-DH and the L-DH. The patients were placed into two groups. Fourteen patients underwent 3 rounds of S-DH testing followed by 3 rounds of L-DH testing. The other fourteen patients underwent 3 rounds of L-DH testing followed by 3 rounds of S-DH testing. The duration of nystagmus and the latency prior to the onset of nystagmus were measured for each test. Additionally, the patients were asked to rate the severity of their symptoms following each test.

RESULTS: The duration of nystagmus of the L-DH was significantly longer than that of the S-DH (p<0.0001). The patients reported a higher severity score with L-DH as compared to with S-DH (p<0.001). The L-DH was found to be more sensitive than the S-DH (p=0.0131).

CONCLUSION: The L-DH produces significantly longer duration of nystagmus, stronger symptoms, and improved sensitivity when compared to the S-DH.

Cite this article as: Andera L, Azeredo WJ, Greene JS, Sun H, Walter J. Optimizing Testing for BPPV – The Loaded Dix-Hallpike. J Int Adv Otol 2020; 16(2): 171-5.

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ISSN1308-7649 EISSN 2148-3817