1. BPPV Cheat Sheet
LEFT DIX­HALLPIKE TEST
Result Involved Canal Treatment
Techniques ­
Canalithiasis
Treatment
Techniques ­
Cupulolithiasis
Upbeating/Left
Torsional Nystagmus
Left Posterior Left Canalith
Repositioning
Technique (CRT)
Liberatory/Semont
Maneuver
Downbeating/Left
Torsional Nystagmus
Left Anterior 1) Deep Head
Hanging
Maneuver
2) Left CRT
Liberatory/Semont
Maneuver
Downbeating/Right
Torsional Nystagmus
Right Anterior 1) Deep Head
Hanging
Maneuver
2) Right CRT
Liberatory/Semont
Maneuver
Lateral Nystagmus Suspect Horizontal
Canal ­ Perform Roll
Test
RIGHT DIX­HALLPIKE TEST
Result Involved Canal Treatment
Techniques ­
Canalithiasis
Treatment
Techniques ­
Cupulolithiasis
Upbeating/Right
Torsional Nystagmus
Right Posterior Right Canalith
Repositioning
Technique (CRT)
Liberatory/Semont
Maneuver
Downbeating/Left
Torsional Nystagmus
Left Anterior 3) Deep Head
Hanging
Maneuver
4) Left CRT
Liberatory/Semont
Maneuver
Downbeating/Right
Torsional Nystagmus
Right Anterior 3) Deep Head
Hanging
Maneuver
4) Right CRT
Liberatory/Semont
Maneuver
Lateral Nystagmus Suspect Horizontal
Canal ­ Perform Roll
Test

2. ROLL TEST
Result Involved Canal Treatment
Techniques ­
Canalithiasis
Treatment
Techniques ­
Cupulolithiasis
Geotropic Nystagmus Side of more robust
nystagmus/greater
symptoms
1) BBQ roll
(slow)
2) Appiani
Maneuver
3) Forced
prolonged
positioning
Apogeotropic
Nystagmus
Side of more robust
nystagmus/greater
symptoms
1) BBQ Roll
(fast)
2) Casani
Maneuver
*For anterior/posterior canal BPPVs, can have patient perform Brandt­Daroff exercises
*There may be a latency up to 40 seconds before nystagmus is observed during testing