What Is a Hallpike Maneuver?

People experiencing dizziness might be given a Hallpike maneuver.
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  • Written By: Eric Stolze
  • Edited By: Lauren Fritsky
  • Last Modified Date: 13 April 2014
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A Hallpike maneuver, also known as a Dix-Hallpike test, is a medical test that a doctor may perform on a patient who has dizziness or vertigo. The Hallpike maneuver is typically used to determine if a patient’s dizziness is caused by an inner ear disorder. Patients with dizziness may undergo a series of tests during a medical examination. After a Hallpike maneuver and other tests, many doctors are better able to diagnose the cause of a patient’s dizziness and recommend an appropriate treatment.

During a Hallpike maneuver, a patient usually sits on a table. A doctor typically lays the patient down very quickly, with the patient situated so that his head hangs over the table’s edge. While the patient lies down, the physician simultaneously turns the patient’s head to the left or the right in most cases. Patients often develop dizziness and nystagmus very quickly from this maneuver if they have an inner ear disorder. Nystagmus is an involuntary eye movement that generally causes fast movement of the eyes in one direction alternating with a smoother eye movement in the other direction.


Other tests for dizziness causes may include hearing tests and heart rate tests. Hearing tests often help a physician determine if a patient has ear dysfunctions that may be contributing to his dizziness. A doctor may check a patient’s heart rate or heart rhythm with a stethoscope while the patient is lying down and immediately after the patient stands up. In some cases, this test can determine if an individual’s dizziness is caused by orthostatic hypotension, a sudden drop in blood pressure. A patient may also stand with his eyes closed so the doctor can see if swaying or other balance problems develop.

Benign paroxysmal positional vertigo is a type of vertigo that typically results from an inner ear disorder and may be discovered when a physician performs a Hallpike maneuver. Patients with this condition often have uneven or abnormal distribution of particles in the canals of the inner ear. These particles are generally used to provide sensitivity to movement and gravity and help people maintain proper balance. The uneven particle distribution in the inner ear usually causes vertigo or episodes of dizziness. Spinning sensations, lightheadedness and a loss of balance may occur with benign paroxysmal positional vertigo as well as blurred vision, vomiting or nausea.

Some physicians use a canalith repositioning procedure during an office visit to reposition the particles in a patient’s inner ear. A doctor typically holds the patient’s head in one position for about 30 seconds, and then holds the head in several other positions with each position lasting about 30 seconds. Some physicians may perform surgery to attach a bone plug in the inner ear in cases where canalith repositioning is not effective. Many patients with dizziness benefit from sitting down immediately when they feel dizzy, and the use of a cane may help patients maintain their balance when walking.


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