Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management

Devaraja, K

doi:10.1007/s00405-018-5088-z

Cited by 47 publications

(39 citation statements)

References 151 publications

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“…Patients with cervicogenic dizziness seem to report a feeling of drunkenness/light‐headedness more often than patients with benign paroxysmal positional vertigo (L'Heureux‐Lebeau, Godbout, Berbiche, & Saliba, ), and less likely to report spinning vertigo than patients with benign paroxysmal positional vertigo and other vestibular disorders (L'Heureux‐Lebeau, Godbout, Berbiche, & Saliba, ; Thompson‐Harvey & Hain, ). Interestingly, this study found that both neck pain groups were more likely to report light‐headedness, which has been suggested to be related to neck‐related dizziness (Devaraja, ; Wrisley, Sparto, Whitney, & Furman, ). Patients in the DN group were more likely to report a rocking sensation.…”

Section: Discussionmentioning

confidence: 58%

“…Still, the concept of so called cervicogenic dizziness or vertigo is controversial (Magnusson & Malmstrom, 2016) as there is no international consensus on diagnostic criteria, and symptoms of patients with both dizziness and neck pain often resemble or overlap with other entities (Yacovino & Hain, 2013). Cervical dizziness is commonly reported as a more vague clinical picture than peripheral vestibular disorders, which at least in the acute phase can be recognized by a combination of spinning vertigo with nausea, vomiting, nystagmus and lateropulsion (Brandt, Dieterich, & Strupp, 2013;Devaraja, 2018;Yacovino & Hain, 2013). Considering the close physiological connections between the vestibular and cervical proprioceptive systems, it is likely that neck pain could modify the clinical picture in patients with dizziness.…”

Section: Introductionmentioning

confidence: 99%

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Neck pain associated with clinical symptoms in dizzy patients—A cross‐sectional study

Knapstad

Nordahl

Skouen

et al. 2019

Physiotherapy Res Intl

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Objective Many patients suffer from concurrent neck pain and dizziness. The aim of this study was to describe the clinical symptoms and physical findings in patients with concurrent neck pain and dizziness and to examine whether they differ from patients with dizziness alone. Methods Consecutive patients with dizziness and neck pain were recruited from an ear–nose–throat department and a spine clinic. They were divided into three groups: patients with dizziness only (n = 100), patients with dizziness as their primary complaint and additional neck pain (n = 138) and finally, patients with neck pain as their primary complaint accompanied by additional dizziness (n = 55). The patients filled in questionnaires regarding their symptom quality, time‐course, triggers of dizziness and the Vertigo Symptom Scale Short Form. The physical examination included Cervical Range of Motion, American College of Rheumatology (ACR) Tender Points, Cervical Pressure Pain Thresholds and Global Physiotherapy Examination 52‐Flexibility. Results Both neck pain groups were more likely to have a gradual onset of dizziness symptoms, more light‐headedness, visual disturbances, autonomic/anxiety symptoms, decreased cervical range of motion, decreased neck and shoulder flexibility and increased number of ACR tender points compared with patients with dizziness alone. The group having dizziness as their primary complaint and also reporting neck pain had the highest symptom severity and tended to report rocking vertigo and increased neck tenderness. The group with neck pain as their primary complaint was more likely to report headache. Conclusion Neck pain is associated with certain dizziness characteristics, increased severity of dizziness and increased physical impairment when compared with dizzy patients without neck pain.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Neck pain associated with clinical symptoms in dizzy patients—A cross‐sectional study

Knapstad

Nordahl

Skouen

et al. 2019

Physiotherapy Res Intl

View full text Add to dashboard Cite

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“…The word “dizziness,” in itself, is insufficient to qualify as a diagnostic criterion. Typical clinical symptoms of CD are suggested to consist of disorientation, lightheadedness, or disequilibrium accompanied by cervical pain, limited range of motion, and reduced balance . In addition, a close temporal relationship between the dizziness and neck symptoms is considered important by some authors (Wrisley et al 2000).…”

Section: Introductionmentioning

confidence: 99%

“…Typical clinical symptoms of CD are suggested to consist of disorientation, lightheadedness, or disequilibrium accompanied by cervical pain, limited range of motion, and reduced balance. 4,5 In addition, a close temporal relationship between the dizziness and neck symptoms is considered important by some authors (Wrisley et al 2000). An ex juvantibus confirmation of the diagnosis-based on the resolution of dizziness after treatment of the neck disorderhas been proposed.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics in patients with cervicogenic dizziness: A systematic review

Knapstad

Nordahl

Goplen

2019

Health Science Reports

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Background and aims Cervicogenic dizziness (CD) is a clinical syndrome of dizziness associated with neck dysfunction. CD represents a considerable diagnostic challenge since dizziness and neck pain are common symptoms with complex and multifactorial etiologies. Both research and clinical work on CD is limited by the lack of accepted diagnostic criteria. The aim of this study was to review clinical studies on CD and to assess current evidence regarding the clinical characteristics of this syndrome. Methods A comprehensive PubMed and MEDLINE search was conducted from the date of inception of the database, with the last search conducted in September 2018. Included studies had to contain operable diagnostic criteria as well as a comparison between patients considered to have CD and a clinical comparison group. Data extracted were clinical outcomes, diagnostic criteria, age, sex, and sample size. Studies were assessed for methodological quality using the Crowe Critical Appraisal Tool. Results Out of 2161 screened studies, eight studies comprising 225 patients met the inclusion criteria. Studies were of low to acceptable methodological quality. The most frequent and consistent clinical characteristic in patients classified as having CD, compared with other populations, was reduced posturographic stability. The most consistent diagnostic criteria were based on the concurrence of neck pain with dizziness after exclusion of other possible reasons for dizziness. Conclusion There are few studies examining clinical characteristics in patients with cervicogenic dizziness. Altered posturography appeared to be the only consistent characteristic used when distinguishing CD from other populations. Diagnostic criteria currently used in research are likely to have low specificity, since they rest on the exclusion of other causes rather than on positive distinctive features. More studies are needed to better understand the clinical interrelations between dizziness and neck pain.

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“…If most, but not all, of the study population is under 45 years old, the study will be included. We will exclude studies treating degenerative cervical spine disorders, Barré-Liéou syndrome, Bow Hunter's syndrome, and Beauty Parlor syndrome [25]. Studies of whiplash without associated dizziness will be excluded.…”

Section: Participantsmentioning

confidence: 99%

Physical therapy interventions for cervicogenic dizziness in a military-aged population: protocol for a systematic review

et al. 2020

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Background: Traumatic cervicogenic dizziness is dizziness that is temporally associated with neck pain and injury after other causes of dizziness have been excluded. It can lead to activity limitations and participation restrictions that may include lost duty or work days. The objective of this systematic review is to determine which interventions are most effective in decreasing dizziness or vertigo and neck pain in military-aged adults with traumatic cervicogenic dizziness. Methods: The literature will be systematically searched using the following online databases: MEDLINE, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, CENTRAL, Cochrane Methodology Register), CINAHL, SCOPUS, Web of Science, and J-STAGE. The review will include randomized controlled trials (RCTs), including cluster RCTs and controlled (non-randomized) clinical trials or cluster trials, and observational studies (including prospective and retrospective comparative cohort and case-control or nested case-control studies) and determine the effectiveness of physical therapy interventions for the treatment of traumatic cervicogenic dizziness in military-aged adults. Assessment of methodological quality will be performed by two independent, blinded reviewers using the PEDro scale. The level of evidence will be determined using the GRADE scale. The primary outcome measures will be change in dizziness and neck pain and disability from baseline to the last available follow-up, measured using the Dizziness Handicap Inventory and Neck Disability Index. Other relevant outcome measures will include self-reported change in symptoms, time to return to duty or work, and quality of life. Discussion: This systematic review will identify, evaluate, and integrate the evidence on the effectiveness of physical therapy interventions for cervicogenic dizziness in a military-aged population. We anticipate our findings may inform individual treatment and future research. Clinical recommendations generated from this systematic review may inform military physical therapy treatment of individuals with cervicogenic dizziness.(Continued on next page)

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Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management

Cited by 47 publications

References 151 publications

Neck pain associated with clinical symptoms in dizzy patients—A cross‐sectional study

Neck pain associated with clinical symptoms in dizzy patients—A cross‐sectional study

Clinical characteristics in patients with cervicogenic dizziness: A systematic review

Physical therapy interventions for cervicogenic dizziness in a military-aged population: protocol for a systematic review

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