The Efficacy of Modified Dix-Hallpike Test by Using Pillow Jacket
Rermrat Wisalee¹, Waipoj Chanvimalueng¹
Affiliation : ¹ Department of Otolaryngology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
Background: Benign paroxysmal positional vertigo (BPPV) causes vertigo in patients. It is the most common type of peripheral vestibular disorder. The patient will have vertigo symptoms while moving the head. The symptoms are usually severe and have duration of seconds.
Objective: To study the efficacy of modified Dix-Hallpike test by using pillow jacket for diagnosis of BPPV patient.
Materials and Methods: The first group was evaluated by using the traditional Dix-Hallpike test and then re-evaluated using the modified Dix- Hallpike test by using pillow jacket, while the modified Dix-Hallpike test was done using pillow jacket and then the traditional Dix-Hallpike test was done in the second group. Patients were assessed for nystagmus using Frenzel glasses recording duration, latency period, and direction of nystagmus. Following completion of the test, each patient was evaluated for pain, ease of use, and level of comfort by using the VAS scale.
Results: Ninety-six patients were recruited into the present study. Forty-eight participants were included in Group 1 using the traditional Dix- Hallpike and then the modified Dix-Hallpike test by using pillow jacket, while forty-five patients were in Group 2 using the modified Dix-Hallpike test by using pillow jacket and then the traditional Dix-Hallpike. There were no significant differences regards to age, gender, laterality, duration of vertiginous symptoms in each attack, or onset of symptoms. No statistical significance was noted in terms of median VAS scores for pain, comfort, or ease of use between the two groups. The sensitivity of the modified Dix-Hallpike test by using pillow jacket was 94.92%, while specificity was 91.43%. McNeMar Kappa tests were equivalent for both the modified Dix-Hallpike test by using pillow jacket and traditional Dix-Hallpike test.
Conclusion: The modified Dix-Hallpike test by using pillow jacket may be reliable, with both high sensitivity and specificity in diagnosing BPPV. This method can be used to assess patients suspected of posterior canal BPPV in cases there is lack of space for head extension, or the patient is unable to change position easily as with the traditional Dix-Hallpike maneuver.
Received 27 June 2022 | Revised 8 August 2022 | Accepted 17 August 2022
DOI: 10.35755/jmedassocthai.2022.10.13682
Keywords : Vertigo; Benign paroxysmal positional vertigo (BPPV); Dix-Hallpike test; Modified Dix-Hallpike test
