Dizziness Test

The dizziness test is used to identify whether dizziness is caused by issues in vertebral arteries or semicircular canals of the inner ear.

How to perform the Dizziness Test?

The patient sits, and the examiner grasps the patient’s head. The examiner actively rotates the patient’s head as far as possible to the right and then to the left, holding the head at the extreme of motion for a short time (10 to 30 seconds) while the shoulders remain stationary. The patient’s head is then returned to neutral.

See Also: Vertebral Artery Test

Next, the patient’s shoulders are actively rotated as far to the right as possible, held for 10 to 30 seconds, and then to the left as far as possible, and held for 10 to 30 seconds while keeping the head facing straight ahead.

• If the patient experiences dizziness in both cases, the problem lies in the vertebral arteries, because in both cases the vertebral artery may be “kinked,” decreasing the blood flow.
• If the patient experiences dizziness only when the head is rotated, the problem lies within the semicircular canals of the inner ear.

Modified Dizziness Test

Fitz-Ritson advocates a modification of the dizziness Test. For the first part of the test, he advocates that the examiner holds the shoulders still while the patient rapidly rotates the head left and right with eyes closed. If vertigo results, the problem is in the vestibular nuclei or muscles and joints of the cervical spine. In addition, patients may lose their balance, veer to one side, or possibly vomit.

The second stage is the same as previously mentioned, except that the eyes are closed. If vertigo is experienced this time, Fitz-Ritson believes that the problem is in the cervical spine because the vestibular apparatus is not being moved.

References & More

1. Orthopedic Physical Assessment by David J. Magee, 7th Edition.
2. Fitz-Ritson D. Assessment of cervicogenic vertigo. J Manipulative Physiol Ther. 1991 Mar-Apr;14(3):193-8. PMID: 2045730. Pubmed