Posterior Canal Benign Paroxysmal Positional
Video demonstrates the nystagmus seen in a positive Dix-Hallpike maneuver in a patient with right posterior canal benign paroxysmal positional vertigo. When the patient is rapidly positioned supine with the right ear down, torsional upbeat nystagmus begins after a short delay, with the torsional component manifested as the top poles of the eyes beating toward the right ear. Note the fatigable intensity of the nystagmus over time. Frenzel goggles eliminate the patient’s ability to fixate and enhance the view of the examiner, although this type of nystagmus will typically be visible without Frenzel goggles.