Fig. 9. Hallpike-Dix maneuver for benign paroxysmal positional vertigo. This figure shows the maneuver of the head and body during the test, along with the labyrinth (enlarged). A. The patient sits on the examination table with the head turned 45 degrees horizontally. B. The head and trunk are quickly brought straight back en bloc so that the head is hanging over the edge of the examination table by 20 degrees. The patient is assessed for nystagmus and is asked whether he or she has vertigo. Although not shown in the figure, the patient is then brought up slowly to a sitting position, with the head still turned 45 degrees, and nystagmus is sought again. This test is then repeated with the head turned 45 degrees in the other direction. This figure also shows movement of free-floating otoconia in the right posterior semicircular canal (large black arrows) during the Hallpike-Dix test. In this example, the patient has nystagmus and vertigo when the test is performed on the right side but not when the test is performed on the left side.