Dizziness physical examination

Physical examination of patients with dizziness is usually remarkable for balance problems and nystagmus on Dix-Hall pike maneuver.

Physical examination of patients includes reproducing dizziness in the clinic by following these maneuvers^{[1][2][3][4][5]}:

• Dix-Hallpike maneuver– Turning the patient’s head at 45 degrees to one side, and rapidly laying the patient into a supine position with the head hanging about 20 degrees over the end of the table, any abnormal eye movement within 30 seconds indicates vestibular debris.
• Orthostatic blood pressure measurement– Drop-in blood pressure from supine to standing position indicates orthostatic hypotension.
• Romberg test– Swaying or leaning towards one side is indicative of ipsilateral vestibular dysfunction.
• Observation of gait- To look for any symptoms of Parkinson’s disease such as small steps and less arm swing.

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