Peter, do you have any common pitfalls to avoid when performing Dix-Hall-Pike maneuvers or any pearls or tips to share for doing this better?

Well, I like the idea of explaining to the patient what you're going to do.

I think that's what I do too.

If they do close their eye, you can actually use your thumb to kind of gently lift up their eyelid so you can see what nystagmus they're having because that's crucial.

And I sit on the stool so that I'm comfortable.

I can support my hand that's holding their head.

And you have to support their head.

So Peter, in a patient with an indeterminate or negative Dix-Hallpike test and supine roll test, what would point you more towards a vestibular migraine diagnosis and how would you manage that?