Which maneuver is used to diagnose BPPV?

• A. Romberg
• B. Dix-Hallpike maneuver
• C. Weber
• D. Rinne

Answer: (B)

BPPV is diagnosed with provocative maneuvers that move otoconia within the vestibular system to trigger vertigo and a characteristic gaze nystagmus. The Dix-Hallpike maneuver is the classic test for this, especially posterior canal involvement. Have the patient start seated, turn the head about 45 degrees to one side, then rapidly lay them back with the head extended about 20 degrees so the affected canal is dependent. Observe for vertigo and a vertical-torsional nystagmus that beats toward the lower eye; this response typically appears within seconds and fatigues with repetition, usually lasting less than a minute. A positive result on one side confirms BPPV and guides treatment with canalith repositioning. Other tests like Romberg assess balance or proprioception, and Weber and Rinne evaluate hearing, not BPPV.