The Hall-Pike Maneuver is a cervical spine examination procedure that assesses for vertebrobasilar ischaemia (VBI).


Patient should be awake and cooperative while the Hall-Pike Maneuver is being performed.

  1. Patient lies down on the examination table but her head will be at the edge of the table.
  2. The examiner supports the patient’s head and passively extends the head and rotates it from side to side.
  3. The examiner takes note of any complaints of vertigo, nystagmus, syncope, visual changes or nausea.

Examiner extends patient’s head and rotates it from side to side.


Positive Hall-Pike Maneuver

There is positive Hall-Pike Maneuver when the patient exhibits signs like syncope, nystagmus, vertigo, visual changes and/or nausea. These signs indicate  vertebroabasilar ischaemia (VBI).

Clinical Notes

The Hall-Pike Maneuver can be used as a screening procedure before cervical manipulation. During this procedure, the patient’s eyes should be open to observe for nystagmus.