Dix-Hallpike Maneuver in Posterior BPPV with Reversal of Nystagmus on Sitting Up

Update item information
Identifier PC_BPPV_with_reversal
Title Dix-Hallpike Maneuver in Posterior BPPV with Reversal of Nystagmus on Sitting Up
Subject BPPV Posterior; BPPV Diagnosis; Jerk Nystagmus; Vestibular Nystagmus
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine; Daniele Nuti, University of Siena; Marco Mandalà, MD, PhD Otology and Skull Base Unit Azienda Ospedaliera Universitaria Senese
Description This is a patient with typical posterior canal (PC) benign paroxysmal positional vertigo (BPPV), which is provoked by the Dix-Hallpike maneuver. When the patient is moved into the right Dix-Hallpike maneuver, after a brief latency, upbeat-torsional (towards the lowermost or affected [right] ear) nystagmus is seen. There is a crescendo-decrescendo pattern and nystagmus and vertigo resolve. With the right Dix-Hallpike maneuver, the right PC is stimulated by movement of the otoconial particles and an excitatory pattern of nystagmus results. In this case, the right superior oblique and left inferior rectus muscles are stimulated which initiates the downward and torsional (towards left ear) slow phase. An upbeat-torsional (towards right ear) fast phase is then generated until the otoconia fall to the most dependent portion of the PC and there is no longer flow of endolymph or deflection of the cupula. However, when the patient is brought from right Dix-Hallpike back to a seated position, the otoconia move in the opposite (inhibitory) direction, and a downbeat-torsional nystagmus is then seen. [[Number of Videos and legend for each: A patient with posterior canal BPPV and reversal of nystagmus when going from Dix-Hallpike to seated positions. ]]
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017-11
Type Image/MovingImage
Format video/mp4
Relation is Part of NOVEL: Neuro-ophthalmology Virtual Education Library Examination Collection
Rights Management Copyright 2017. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s6ng8nbm
Setname ehsl_novel_gold
Date Created 2017-11-20
Date Modified 2021-05-06
ID 1281864
Reference URL https://collections.lib.utah.edu/ark:/87278/s6ng8nbm