The Dix-Hallpike test (also called Nylen-Barany test) determines whether vertigo is triggered by certain head movements. Your doctor will carefully observe any involuntary eye movements (nystagmus) that may occur during this test to determine if the cause of your vertigo is central or peripheral. Central vertigo is caused by a problem inside the brain, and peripheral vertigo is caused by a problem with the inner ear or the nerve leaving the inner ear. The Dix-Hallpike test also can help determine which ear is likely affected. During the test:

• You sit with your legs extended on the examination table. Your doctor turns your head 30º to 45º toward one side and helps you quickly lie back so your head hangs over the end of the table.
• Your doctor watches your eyes for involuntary eye movements (called nystagmus). The timing and appearance of the eye movements will identify the cause of vertigo as either the inner ear or the brain.
• After you sit upright for a few minutes to recover from the vertigo, the procedure is repeated with your head turned in the opposite direction.

Why It Is Done

The Dix-Hallpike test locates the cause of vertigo as either the inner ear or the brain. If the problem is in the ear, this test can determine which ear is affected.

Results

A normal test result means that you did not have vertigo or nystagmus during the test.

An abnormal test result means that you had vertigo or nystagmus during the test. It is likely that the vertigo is caused by an inner ear or brain problem, depending on the way you reacted to the test.

What To Think About

The test can be uncomfortable because of the vertigo and nausea that may result.

The test is inexpensive, easy to do, and is commonly done as part of the physical exam when you visit your doctor for complaints of dizziness or vertigo.

Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.