Vertigo in Patients with Degenerative Cervical Myelopathy

Abstract

(1) Background: Cervical vertigo (CV) represents a controversial entity, with a prevalence ranging from reported high frequency to negation of CV existence. (2) Objectives: To assess the prevalence and cause of vertigo in patients with a manifest form of severe cervical spondylosis–degenerative cervical myelopathy (DCM) with special focus on CV. (3) Methods: The study included 38 DCM patients. The presence and character of vertigo were explored with a dedicated questionnaire. The cervical torsion test was used to verify the role of neck proprioceptors, and ultrasound examinations of vertebral arteries to assess the role of arteriosclerotic stenotic changes as hypothetical mechanisms of CV. All patients with vertigo underwent a detailed diagnostic work-up to investigate the cause of vertigo. (4) Results: Symptoms of vertigo were described by 18 patients (47%). Causes of vertigo included: orthostatic dizziness in eight (22%), hypertension in five (14%), benign paroxysmal positional vertigo in four (11%) and psychogenic dizziness in one patient (3%). No patient responded positively to the cervical torsion test or showed significant stenosis of vertebral arteries. (5) Conclusions: Despite the high prevalence of vertigo in patients with DCM, the aetiology in all cases could be attributed to causes outside cervical spine and related nerve structures, thus confirming the assumption that CV is over-diagnosed.

Cervicogenic Dizziness in an 11-Year-Old Girl: A Case Report

“…4 The overall prevalence of CGD is not known because there are no generally accepted clinical or paraclinical tests for CGD. 26 …”

Insights into Benign Paroxysmal Positional Vertigo in the Elderly

“…Cervical vertigo refers to a delusional movement caused by cervical degenerative disease and vertebral artery compression (27). Its clinical manifestations are similar to BPPV, but its important distinguishing point is persistent vertigo or nystagmus with neck the following body rotates.…”

Dizziness: efficient approach to treatment and prevention

“…Самым тяжелым вариантом головокружения является вращательное головокружение -иллюзия движения, при которой человек ощущает, что он или окружаю щие объекты движутся, даже если человек совершенно неподвижен 1 . Причинами вращательного головокружения могут быть доброкачественное пароксизмальное позиционное головокружение, акустическая неврома, болезнь Меньера, лабиринтит, вестибулярный нейронит, вестибулярная мигрень (мигрень-ассоциированное головокружение), инсульт ствола головного мозга или мозжечка, токсическое поражение вестибулярного аппарата (например, алкоголь), эпилепсия, вестибулярная пароксизмия [4][5][6][7]. В диагностический протокол пациентов с вращательным головокружением входит магнитно-резонансная томография головного мозга, магнитно-резонансная артериография, консультация оториноларинголога, аудиометрия.…”