If performing a Dix-Hallpike is not possible, what is an alternative test for assessing BPPV?

The side-lying test is an effective alternative for assessing Benign Paroxysmal Positional Vertigo (BPPV) when the Dix-Hallpike maneuver cannot be performed. This test can help elicit the characteristic vertiginous symptoms and nystagmus associated with BPPV by having the patient lie on their side, allowing the clinician to assess the response from the affected ear in a controlled position.

In contrast, VNG (Video Nystagmography) and posturography are valuable tools in evaluating balance and vestibular function but are not specific tests for identifying BPPV. The nystagmus test may provide information on eye movement and vestibular function, but it does not specifically assess for the positional changes required to diagnose BPPV effectively. Therefore, the side-lying test stands out as a necessary and relevant alternative when the traditional Dix-Hallpike maneuver is impractical.