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Three Part Question

In [a patient presenting to the Accident and Emergency department with acute positional vertigo] will a [positive Dix Hallpike test] indicate a [definite diagnosis of posterior semicircular canal BPPV vs anything else]?

Clinical Scenario

You are the Emergency Department physician seeing a 76 year old gentleman who reports short-lasting episodes of debilitating dizziness. Upon further questioning you elicit that these usually occur in the morning or at night when he is in bed and turns to the right. His physical examination is normal, as is an ECG, postural blood pressure testing and other baseline observations. You suspect that he has benign paroxysmal positional vertigo from semicircular canalithiasis in the right ear but wonder whether a positive Dix Hallpike test in the right ear would provide you with a definitive diagnosis of posterior semicircular canal BPPV. This will enable you to discharge him having performed an Epley manoeuvre to alleviate his symptoms.

Search Strategy

1. Pubmed
2. Ovid interface on the world wide web 1966-Jun 2009
1. (dix[All Fields] AND hallpike[All Fields]) AND (("diagnosis"[MeSH Terms] OR "diagnosis"[All Fields] OR "diagnostic"[All Fields]) OR predictive[All Fields]) AND value[All Fields]

2.(dix[All Fields] AND hallpike[All Fields]) AND (("diagnosis"[MeSH Terms] OR "diagnosis"[All Fields] OR "diagnostic"[All Fields]) OR predictive[All Fields]) AND value[All Fields]