Which vestibular assessment maneuver is used to determine whether nystagmus will occur as a result of a rapid body movement?

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

Answer: (B)

Positional provocation of nystagmus to diagnose BPPV is best tested with the Dix-Hallpike maneuver. In this test you rapidly move the patient from sitting to a supine position with the head turned to one side and extended. This specific movement positions the posterior semicircular canal so that loose otoconia can move within it. If canalithiasis is present, the resulting endolymph flow induces a short-latency nystagmus and vertigo, often with a distinctive torsional component toward the affected ear. This pattern helps confirm BPPV and localize the involved canal, making the maneuver diagnostic rather than therapeutic. The other options aren’t designed to provoke movement-induced nystagmus in this way—Epley is a treatment, while gaze testing and Bárány-related procedures assess eye movements or use different vestibular tests.