Clinical Characteristics of Cervicogenic-Related Dizziness and Vertigo

Yacovino, Darío Andrés; Hain, Timothy C.

doi:10.1055/s-0033-1354592

Cited by 79 publications

(40 citation statements)

References 82 publications

(73 reference statements)

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“…CD has several proposed causes, such as vascular or neurovascular. 6 However, the most common theory is considering CD to be a disorder of neck proprioception. 1,7 Furman and Cass 7 defined it as a "nonspecific sensation of altered orientation in space and disequilibrium originating from abnormal afferent activity from the neck."…”

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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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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“…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%

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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“…However, because of the lack of a specific diagnostic test, cervical vertigo is a controversial entity. [4] According to our experience, a strict diagnose of cervical vertigo should be based on patients’ episode of sympathetic cervical spondylosis with other vertigo-inducing causes excluded. Several hypotheses regarding the etiology of cervical vertigo, such as neurovascular, somatosensory input, vascular and cervical instability, have been put forward.…”

Section: Discussionmentioning

confidence: 99%

“…Several hypotheses regarding the etiology of cervical vertigo, such as neurovascular, somatosensory input, vascular and cervical instability, have been put forward. [4] In the present study, we used MRI to investigate the relationship between the longus colli muscles and cervical vertigo.…”

Section: Discussionmentioning

confidence: 99%

“…[1] One form of vertigo, cervical vertigo, is caused by neck disorders and is the most controversial. [2] Several hypotheses about cervical vertigo have been put forward, [3,4] but no study has investigated the relationship between the longus colli muscle and cervical vertigo. Previous studies have focused mainly on how the deep cervical flexor (DCF) muscles affect chronic neck pain.…”

Section: Introductionmentioning

confidence: 99%

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Does the longus colli have an effect on cervical vertigo?

et al. 2017

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The aim of the study was to evaluate the role of the longus colli muscles in cervical vertigo.We retrospectively analyzed 116 adult patients who underwent anterior cervical discectomy and fusion (ACDF) during 2014 in our department. Patients were assigned to the vertigo group or the nonvertigo group. Demographic data were recorded. Inner distance and cross-sectional area (CSA) of longus colli were measured using coronal magnetic resonance imaging (MRI).The vertigo group (n = 44) and the nonvertigo group (n = 72) were similar in demographic data. Mean preoperative Japanese Orthopaedic Association (JOA) score was higher in the vertigo group than in the nonvertigo group (P = 0.037), but no difference postoperatively. Mean JOA scores increased significantly postoperatively in both groups (P = 0.002 and P = 0.001). The mean vertigo score decreased significantly from pre- to postoperatively in the vertigo group (P = 0.023). The mean preoperative Cobb angle was significantly smaller in the vertigo group than in the nonvertigo group (P <0.001), but no significant difference postoperatively. After ACDF, the mean Cobb angle increased significantly in the vertigo group (P <0.001). The instability rates of C3/4 and C4/5 were significantly higher in the vertigo group (P <0.001 and P <0.001). The inner distance of longus colli was significantly shorter (P = 0.032 and P = 0.026) and CSA significantly smaller (P = 0.041 and P = 0.035), at C3/4 and C4/5 in the vertigo group than in the nonvertigo group. Mean Miyazaki scores were significantly higher in the vertigo group at C3/4 and C4/5 (P = 0.044 and P = 0.037). Moreover, a shorter inner distance and smaller CSA were related to a higher Miyazaki score.Inner distance and cross-sectional area (CSA) of longus colli are associated closely with cervical vertigo. Shorter inner distance and smaller CSA of the longus colli muscles might be risk factors for cervical vertigo. ACDF provided a good resolution of cervical vertigo.

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Clinical Characteristics of Cervicogenic-Related Dizziness and Vertigo

Cited by 79 publications

References 82 publications

Clinical characteristics in patients with cervicogenic dizziness: A systematic review

Clinical characteristics in patients with cervicogenic dizziness: A systematic review

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

Does the longus colli have an effect on cervical vertigo?

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