Which maneuver is commonly used to diagnose BPPV by provoking positional vertigo and nystagmus?

Which maneuver is commonly used to diagnose BPPV by provoking positional vertigo and nystagmus?

• A. Epley
• B. Dix-Hallpike
• C. Bárány
• D. Gaze

Answer: (A)

Diagnosing BPPV relies on provoking the positional changes that cause the vertigo and the telltale eye movements. The preferred diagnostic move is the Dix-Hallpike maneuver. In this test, the head is turned to one side and then laid back with the head extended so the posterior semicircular canal is gravity-dependent. If BPPV is present, vertigo typically begins after a brief delay and lasts less than a minute, accompanied by a characteristic pattern of nystagmus that is usually upbeating with a torsional component toward the affected ear. Observing both the timing and the direction of the nystagmus helps confirm BPPV and indicates which canal is involved. The Epley maneuver, by contrast, is a treatment sequence designed to move displaced otoconia out of the canal and into the vestibule, rather than to diagnose. The other options aren’t standard diagnostic maneuvers for provoking the specific positional vertigo and nystagmus seen in BPPV.

Diagnosing BPPV relies on provoking the positional changes that cause the vertigo and the telltale eye movements. The preferred diagnostic move is the Dix-Hallpike maneuver. In this test, the head is turned to one side and then laid back with the head extended so the posterior semicircular canal is gravity-dependent. If BPPV is present, vertigo typically begins after a brief delay and lasts less than a minute, accompanied by a characteristic pattern of nystagmus that is usually upbeating with a torsional component toward the affected ear. Observing both the timing and the direction of the nystagmus helps confirm BPPV and indicates which canal is involved.

The Epley maneuver, by contrast, is a treatment sequence designed to move displaced otoconia out of the canal and into the vestibule, rather than to diagnose. The other options aren’t standard diagnostic maneuvers for provoking the specific positional vertigo and nystagmus seen in BPPV.