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Dix-Hallpike Maneuver

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1. Qualitative analysis of the Dix-Hallpike maneuver in multi-canal BPPV using a biomechanical model: Introduction of an expanded Dix-Hallpike maneuver for enhanced diagnosis of multi-canal BPPV (PubMed)

Qualitative analysis of the Dix-Hallpike maneuver in multi-canal BPPV using a biomechanical model: Introduction of an expanded Dix-Hallpike maneuver for enhanced diagnosis of multi-canal BPPV Multiple canal BPPV can be a diagnostic challenge to the clinician. This is due in part to the complex anatomy of the labyrinth but also to complex and often simultaneous ocular responses that result from stimulation of multiple canals during traditional diagnostic testing. Our objective was to analyze (...) the Dix-Hallpike maneuver used in the diagnosis of BPPV to look for patterns of simultaneous canal response and to develop a diagnostic maneuver that will allow separation of canal responses in multiple canal BPPV.A previously created and published 3D biomechanical model of the human labyrinths for the study of BPPV was used to analyze and compare the position and movement of otoliths in the Dix-Hallpike maneuver as well as in a proposed expanded version of the traditional Dix-Hallpike maneuver.The

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2017 World journal of otorhinolaryngology - head and neck surgery

2. “Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation (PubMed)

“Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation Introduction Benign Paroxysmal Positional Vertigo is the most common cause of dizziness in elderly people. Recent studies have shown that the elderly present higher Benign Paroxysmal Positional Vertigo recurrence and that vertiginous symptomatology remission varies according to comorbidities and the therapeutic (...) techniques applied. Objective To assess the short-term effectiveness of Vestibular Rehabilitation in addition to Canalith Repositioning Maneuver on positive to negative Dix-Hallpike test, on recurrence and number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo. Methods In this randomized controlled trial, 7 older adults (median age: 69 years, range 65-78) underwent Canalith Repositioning Maneuver and Vestibular Rehabilitation for thirteen

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2016 International archives of otorhinolaryngology

3. Dix-Hallpike Maneuver

Dix-Hallpike Maneuver Dix-Hallpike Maneuver Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Dix-Hallpike Maneuver Dix-Hallpike (...) Maneuver Aka: Dix-Hallpike Maneuver II. Definition Vestibular Testing III. Indication Exam evoked by position change No symptoms at rest IV. Contraindications Elderly with significant carotid vascular disease V. Procedure Patient starts in sitting position on exam table Facing forward with eyes open Rapidly lie patient backward Head turned 45 degrees to RIGHT Neck extended 20 degrees hanging over end of table Patient remains in this position for 30 seconds Sit patient up Rapidly lie patient backward

2018 FP Notebook

4. Behavior of the Posterior Semicircular Canal After Dix-Hallpike Maneuver (PubMed)

Behavior of the Posterior Semicircular Canal After Dix-Hallpike Maneuver The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix-Hallpike maneuvers

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2016 Audiology research

5. Dix-Hallpike Positive, No Red Flags, Now What?

Dix-Hallpike Positive, No Red Flags, Now What? Dix-Hallpike Positive, No Red Flags, Now What? – Clinical Correlations Search Dix-Hallpike Positive, No Red Flags, Now What? January 23, 2010 3 min read The Proper Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo Carly Oboudiyat Faculty peer reviewed You finally have the “dizzy” patient whose eyes actually beat torsionally upwards when you do that silly maneuver you have done countless times to no avail. Hallelujah, you think (...) , a positive Dix-Hallpike sign, reassuring you that you have a case of benign paroxysmal positional vertigo (BPPV). But now what? Do you try that other acrobatic maneuver to reposition the canaliths in the posterior canal, or should you give meclizine? Benign paroxysmal positional vertigo has a lifetime prevalence of 2.4%.[1] It is thought to result from the anomalous position of calcium carbonate otoliths in the inner ear stimulating the ampulla erroneously. The otoliths break off from the macula, and due

2010 Clinical Correlations

6. Dix-Hallpike Maneuver

Dix-Hallpike Maneuver Dix-Hallpike Maneuver Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Dix-Hallpike Maneuver Dix-Hallpike (...) Maneuver Aka: Dix-Hallpike Maneuver II. Definition Vestibular Testing III. Indication Exam evoked by position change No symptoms at rest IV. Contraindications Elderly with significant carotid vascular disease V. Procedure Patient starts in sitting position on exam table Facing forward with eyes open Rapidly lie patient backward Head turned 45 degrees to RIGHT Neck extended 20 degrees hanging over end of table Patient remains in this position for 30 seconds Sit patient up Rapidly lie patient backward

2015 FP Notebook

7. Head Shaking During Dix-Hallpike Exam Increases the Diagnostic Yield of Posterior Semicircular Canal BPPV. (PubMed)

Head Shaking During Dix-Hallpike Exam Increases the Diagnostic Yield of Posterior Semicircular Canal BPPV. To examine whether shaking the head during the DH exam (HSDH) may improve diagnosis of posterior semicircular canal benign paroxysmal positional vertigo (pBPPV) in patients with a negative Dix-Hallpike (DH) examination.A prospective cohort clinical study on consecutive patients with dizziness, who were seen by 2 experienced neurotologists. Patients underwent a complete neurotology (...) examination, including positioning testing with roll test and DH. Patients with a negative DH underwent a HSDH. Patients with a positive DH (Group 1) or only with a positive HSDH (Group 2) underwent a particle reposition maneuver (PRM), which was a modification of the Epley maneuver. Variables including sex, age, the duration of symptoms until diagnosis, and the number of visits required until cure were examined in each group.A tertiary dizziness clinic and in 2 private clinics.All patients diagnosed

2013 Otology and Neurotology

8. Switch to Semont maneuver is no better than repetition of Epley maneuver in treating refractory BPPV. (PubMed)

, Chi-square test). However, the patients with a long duration (p < 0.001, linear regression) and latency (p = 0.01) of the positional nystagmus during Dix-Hallpike maneuver showed a higher rate of the initial and second treatment failures. Either Epley or Semont maneuver may be applied as a second treatment to the patients with PC-BPPV refractory to the initial Epley maneuver. This study provides Class I evidence that repeated Epley and switch to Semont maneuver shows a similar efficacy in treating (...) Switch to Semont maneuver is no better than repetition of Epley maneuver in treating refractory BPPV. The objectives of this study is to compare the efficacy between repetition of Epley maneuver and switch to alternate Semont maneuver in treating posterior canal benign paroxysmal positional vertigo (PC-BPPV) that does not respond to the initial Epley maneuver. In the nationwide, seven dizziness clinics of Korea, 506 consecutive patients (303 women, age range 22-87, mean age ± SD = 64 ± 12

2018 Journal of neurology

9. Canal Conversion and Reentry: A Risk of Dix-Hallpike During Canalith Repositioning Procedures. (PubMed)

maneuvers for canal conversion or reentry in 1 session.Incidence and timing of onset of H-BPPV or common crus reentry and the outcome of treatment maneuvers.H-BPPV or reentry occurred during the Dix-Hallpike after a canal-clearing CRP and affected 16% (7/44) of subjects. Approximately 87% (7/8) of reentry or conversion events occurred after the very first CRP. Geotropic H-BPPV occurred in 9% (4/44) overall but in 13% (4/30) whose P-BPPV was resolved by a single CRP. All were cleared with H-BPPV (...) maneuvers, 3 of 4 resolving with a single Gufoni maneuver. Approximately 9% (4/44) of patients developed reentry of particles into the common crus. It was treated by raising the patient to the upright position. By waiting 15 minutes after treatment of reentry, a final normal Dix-Hallpike was obtained without causing reentry into any canal in all patients.If the first CRP clears the posterior canal, there is an elevated risk of reentry or canal conversion if another Dix-Hallpike is performed immediately

2011 Otology and Neurotology

10. Effect of a hybrid maneuver in treating posterior canal benign paroxysmal positional vertigo. (PubMed)

received weekly administration of the maneuver until resolution of symptoms. The Dix-Hallpike test was performed before treatment at every appointment, and finally after 1 mo from the last maneuver.Nystagmus duration and vertigo intensity were recorded. The supine roll test was performed in case the Dix-Hallpike test was negative to test otoconial migration. Data were analyzed with repeated-measures analysis of variance, paired t-tests with a Bonferroni correction, and the Spearman rank correlation (...) Effect of a hybrid maneuver in treating posterior canal benign paroxysmal positional vertigo. Benign paroxysmal positional vertigo (BPPV) is the most common disorder of the vestibular system of the inner ear, which is a vital part of maintaining balance. Although the efficacy of the Epley maneuver-also known as the canalith repositioning maneuver (CRM)-is well established, data comparing CRM versus a hybrid treatment are lacking.The purpose of this study was to determine the effect of a hybrid

2018 Journal of the American Academy of Audiology

11. An Abbreviated Diagnostic Maneuver for Posterior Benign Positional Paroxysmal Vertigo (PubMed)

of the Dix-Hallpike maneuver, which can be used to diagnose this disease. It is similar to the standard maneuver but can be performed without an examination bed/table and requires only a backed chair (a difference that we feel is very important in settings where a clinical bed/table is not readily available).A diagnostic assessment study was conducted in 163 patients who presented with vertigo or dizziness.The abbreviated test had fairly good sensitivity (80%) and high specificity (95%) for diagnosing (...) An Abbreviated Diagnostic Maneuver for Posterior Benign Positional Paroxysmal Vertigo Benign paroxysmal positional vertigo (BPPV) secondary to canalolithiasis of the posterior semicircular canal is perhaps the most frequent cause of vertigo and dizziness. One of its properties is a high response rate to canalith repositioning maneuvers. However, delays in the diagnosis and treatment of this entity can range from days to years, depending on the setting. Here, we present an abbreviated variation

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2016 Frontiers in neurology

12. Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo. (PubMed)

twice and rotated 120° per step, whereas 177 patients in the multi-step maneuver (MSM) group were accelerated 4 times and rotated 60° per step. Dix-Hallpike (DH) tests were performed to categorize the treatment outcome as follows: 'symptom free' if the result was negative, 'symptom persistent' if the result remained positive after performing the maneuver 3 times or 'canal conversion' if horizontal nystagmus was evoked.Of the patients in the SSM and MSM groups, 78.4 and 91.5% became symptom free (...) Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo. This study aims to investigate the roles of the number of accelerations and rotation angle in the treatment of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).We enrolled 344 patients with unilateral PC-BPPV. Of these, 167 patients in the simple-step maneuver (SSM) group were accelerated

2016 ORL; journal for oto-rhino-laryngology and its related specialties

13. Effects of postural restriction after modified Epley maneuver on recurrence of benign paroxysmal positional vertigo. (PubMed)

treated in the Otorhinolaryngology Department of Susehri State Hospital. The Dix-Hallpike test was performed on all patients. After the involved canal was identified using this test, we guided patients through the modified Epley repositioning maneuver. A maximum of two maneuvers were performed in the same session. The patients were randomly divided into two groups. One group was not advised any positional restriction, while the second group was advised positional restriction for 10 days after (...) Effects of postural restriction after modified Epley maneuver on recurrence of benign paroxysmal positional vertigo. In the present study, we calculated the success rate of the modified Epley maneuver and determined the effectiveness of post-maneuver positional restriction in terms of the prevention of early and late recurrence.The present study was conducted on 78 patients who had unilateral benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal (SCC) and who were

2014 Auris, nasus, larynx

14. Rapid Systematic Review of the Epley Maneuver for Treating Posterior Canal Benign Paroxysmal Positional Vertigo. (PubMed)

%-76%]) or conversion to a negative Dix-Hallpike (absolute risk differences ranging from 17% [95% CI, -5%-37%] to 64% [95% CI, 29%-79%]). At 1-month follow-up, the results of the included studies diverged further. Absolute risk differences ranged from 6% (95% CI, -24%-35%) more symptom relief in favor of watchful waiting to 79% (95% CI, 56%-88%) in favor of the Epley maneuver.All data of the selected studies show a benefit in favor of the Epley maneuver at 1-week follow-up in the management of p (...) Rapid Systematic Review of the Epley Maneuver for Treating Posterior Canal Benign Paroxysmal Positional Vertigo. The aim of this study was to compare watchful waiting to the Epley maneuver as a management option for patients with posterior canal benign paroxysmal positional vertigo (p-BPPV) regarding symptom relief.PubMed, Embase, and The Cochrane Library.A systematic search was conducted. Studies reporting original study data were included. Relevance and risk of bias (RoB) of the selected

2014 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

15. Rapid Systematic Review of the Epley Maneuver versus Vestibular Rehabilitation for Benign Paroxysmal Positional Vertigo. (PubMed)

Rapid Systematic Review of the Epley Maneuver versus Vestibular Rehabilitation for Benign Paroxysmal Positional Vertigo. To evaluate the effectiveness of the Epley maneuver compared with vestibular rehabilitation on patient-reported symptom relief and conversion of the Dix-Hallpike from positive to negative in patients with posterior benign paroxysmal positional vertigo (p-BPPV).PubMed, Embase, and the Cochrane Library.A systematic search was conducted. Studies reporting original study data (...) follow-up with regard to patient-reported symptom relief and conversion of the Dix-Hallpike maneuver from positive to negative (risk differences range from 10% [95% CI, 30-47] to 55% [95% CI, 35-71]). There is inconsistent evidence for the effectiveness of the Epley maneuver compared with vestibular rehabilitation at 1-month follow-up. Most studies suggest that the Epley maneuver and vestibular rehabilitation are equally effective at 1-month follow-up.The Epley maneuver is more effective in treating

2014 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

16. Double-blind randomized trial on short-term efficacy of the Semont maneuver for the treatment of posterior canal benign paroxysmal positional vertigo. (PubMed)

. Patients were randomly assigned to treatment by SLM (n = 174) or sham treatment (n = 168). Subjects were followed up twice (1 and 24 h) with the Dix-Hallpike maneuver by blinded examiners. At the 1 and 24 h follow-up, 79.3 and 86.8%, respectively, of patients undergoing SLM had recovered from vertigo, compared to none of the patients undergoing the sham maneuver (p < 0.0001). Patients who manifested liberatory nystagmus at the end of SLM showed a significantly higher percentage of recovery (87.1 vs (...) Double-blind randomized trial on short-term efficacy of the Semont maneuver for the treatment of posterior canal benign paroxysmal positional vertigo. The need for Class I and II studies on the efficacy of Semont's liberatory maneuver (SLM) in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV) motivated the present double-blind randomized trial on the short-term efficacy of SLM. A total of 342 patients with unilateral PC-BPPV were recruited for a multicenter study

2012 Journal of neurology

17. Particle repositioning maneuver versus Brandt-Daroff exercise for treatment of unilateral idiopathic BPPV of the posterior semicircular canal: a randomized prospective clinical trial with short- and long-term outcome. (PubMed)

(PRM).Randomized prospective clinical trial.Tertiary referral center.Patients were included in this study if they complained of vertigo and had been diagnosed as having unilateral idiopathic PC-BPPV for at least 1 week before Dix-Hallpike maneuver (DHM), remained for 30 days in the randomly assigned treatment, and had at least 48 months' follow-up.Forty-one patients were treated with a single PRM and 40 patients by B-D exercise.Resolution of benign paroxysmal positional nystagmus on the DHM (...) Particle repositioning maneuver versus Brandt-Daroff exercise for treatment of unilateral idiopathic BPPV of the posterior semicircular canal: a randomized prospective clinical trial with short- and long-term outcome. To compare the outcome and probability of recurrence in a series of patients with unilateral idiopathic benign paroxysmal positional vertigo of the posterior canal (PC-BPPV) that were randomly treated by Brandt-Daroff exercise (B-D exercise) or by particle repositioning maneuver

2012 Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

18. Short-term efficacy of Semont maneuver for benign paroxysmal positional vertigo: a double-blind randomized trial. (PubMed)

was based on the symptomatic status and the Dix-Hallpike maneuver on the fourth day. At this time, patients in both groups with a still positive Dix-Hallpike test were treated with Semont maneuver, and outcome was again assessed on the seventh day.On the fourth day, 55 (84.62%) of 65 patients in the treatment group showed complete resolution of symptoms compared with 9 (14.29%) of 63 patients in the control group. (p < 0.001) 59 (90.77%) of 65 and 52 (82.54%) of 63 patients reported resolution (...) Short-term efficacy of Semont maneuver for benign paroxysmal positional vertigo: a double-blind randomized trial. To assess the short-term efficacy of Semont maneuver for unilateral posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).The short-term efficacy of Semont maneuver was compared with a sham procedure in 128 patients with PC-BPPV by using a double-blinded prospective randomized controlled trial in the setting of a neurologic outpatient clinic in China. Analysis

2012 Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

19. Can We Predict the Efficacy of the Semont Maneuver in the Treatment of Benign Paroxysmal Positional Vertigo of the Posterior Semicircular Canal? (PubMed)

for 3 years (September 2007 to August 2010).Semont maneuver.Duration of the latency period and nystagmus status with the Dix-Hallpike test. Presence or absence of orthotropic nystagmus in the second position of the Semont maneuver. Effectiveness of the Semont maneuver (cure versus no cure).The Semont maneuver is effective in 73% of the patients. Orthotropic nystagmus was present in 67% of the cases and absent in 33%; when we found orthotropic nystagmus, the maneuver was effective in 81 (...) % of the patients, but only in 57% if this nystagmus was not present (Fisher's exact test, p = 0.004; odds ratio, 3.308; 95% confidence interval, 1.492-7.334). The maneuver's efficacy and the presence of orthotropic nystagmus were not affected by the duration of nystagmus status in the Dix-Hallpike test. The duration of the latency period had no effect on the maneuver's efficacy, but it did affect the appearance of orthotropic nystagmus (Mann-Whitney test, p = 0.016).The presence of orthotropic nystagmus

2011 Otology and Neurotology

20. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review (PubMed)

Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo.The purpose of this systematic review was to determine whether patients diagnosed with posterior canal (PC) BPPV, based on positional testing, and treated with a particle repositioning maneuver will show the resolution of benign paroxysmal positional nystagmus (BPPN) on the Dix-Hallpike (...) Test performed 24 hours or more after treatment.Data were obtained from an electronic search of the MEDLINE, EMBASE, and CINAHL databases from 1966 through September 2009.The study topics were randomized controlled trials (RCTs), quasi-RCTs, the diagnosis of PC BPPV, treatment with the particle repositioning maneuver, and outcome measured with a positional test 24 hours or more after treatment.Data extracted were study descriptors and the information used to code for effect size.In 2 double-blind

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2010 EvidenceUpdates

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