Cervicogenic vertigo: etiology, diagnosis and treatment
Abstract
Background and Aim: Cervicogenic dizziness is induced by a specific neck position and the earth’s gravity has no effect on provoking of it. The precise incidence of cervicogenic dizziness is not certain but, 20-58% of patients following sudden head injuries experience its symptoms. In this article, the etiology, diagnosis and treatment of cervicogenic vertigo is discussed.
Methods: At first, articles of cervicogenic dizziness from electronic databases of Google scholar, PubMed, Scopus, Ovid and CINAHL were searched from 1987 up to 2012. Then, the articles in them vertigo, disequilibrium or nystagmus were consistent with neck disorders were searched.
Conclusion: Articles with title of cervicogenic vertigo (cervical vertigo) were limited. Clinical researches about cervicogenic vertigo up to now implicate on several points; all signify that we cannot diagnose it certainly and there is not any specific single test for that. Recently, smooth pursuit neck torsion test (SPNTT) has introduced for diagnosis of cervicogenic vertigo that is not valid yet. There is no protocol for diagnosis of cervicogenic vertigo and diagnosis is often based on limited clinical experiences of clinicians. Physiotherapy, medication and manual therapies are options for treatment but there is no distinct and effective treatment for it and in just one article, a combination of treatments for cervicogenic vertigo as a protocol has recommended.
1. Brandt T, Bronstein AM. Cervical vertigo. J Neurol Neurosurg Psychiatry. 2001;71(1):8-12.
2. Poole E, Treleaven J, Jull G. The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther. 2008;13(4):317-24.
3. Yahia A, Ghroubi S, Jribi S, Mâlla J, Baklouti S, Ghorbel A, et al. Chronic neck pain and vertigo: is a true balance disorder present? Ann Phys Rehabil Med. 2009;52(7-8):556-67.
4. Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther. 2005;10(1):4-13.
5. Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134(9 Pt 2):823-32.
6. Schenk R, Coons LB, Bennett SE, Huijbregts PA. Cervicogenic dizziness: a case report illustrating orthopaedic manual and vestibular physical therapy comanagement. J Man Manip Ther. 2006;14(3):56-68.
7. Cote P, Mior SA, Fitz-Ritson D. Cervicogenic vertigo: a report of three cases. J Can Chiropr Assoc. 1991;35(2):89-94.
8. Ardiç FN, Topuz B, Kara CO. Impact of multiple etiology on dizziness handicap. Otol Neurotol. 2006;27(5):676-80.
9. Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Man Ther. 2008;13(4):357-66.
10. Ryan GM, Cope S. Cervical vertigo. Lancet. 1955;269(6905):1355-8.
11. Karlberg M, Magnusson M, Malmström EM, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Arch Phys Med Rehabil. 1996;77(9):874-82.
12. Clendaniel RA, Landel R. Non-vestibular diagnosis and imbalance: cervicogenic dizziness. In: Herdman S, editor. Vestibular rehabilitation. 3rd ed. Philadelphia: FA Davis Company; 2007. p. 467-83.
13. Corneil BD, Olivier E, Munoz DP. Neck muscle responses to stimulation of monkey superior colliculus. I. Topography and manipulation of stimulation parameters. J Neurophysiol. 2002;88(4):1980-99.
14. Reddy RS, Maiya GA, Rao SK. Proprioceptive reposition errors in subjects with cervical spondylosis. IJHSR. 2012;1(2):65-73.
15. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control--Part 2: case studies. Man Ther. 2008;13(3):266-75.
16. Mergner T, Siebold C, Schweigart G, Becker W. Human perception of horizontal trunk and head rotation in space during vestibular and neck stimulation. Exp Brain Res. 1991;85(2):389-404.
17. Kogler A, Lindfors J, Odkvist LM, Ledin T. Postural stability using different neck positions in normal subjects and patients with neck trauma. Acta Otolaryngol. 2000;120(2):151-5.
18. Dieterich M, Pollmann W, Pfaffenrath V. Cervicogenic headache: electronystagmography, perception of verticality and posturography in patients before and after C2-blockade. Cephalalgia. 1993;13(4):285-288.
19. Mckenna GJ, Peng GC, Zee DS. Neck muscle vibration alters visually perceived roll in normals. J Assoc Res Otolaryngol. 2004;5(1):25-31.
20. Kavounoudias A, Gilhodes JC, Roll R, Roll JP. From balance regulation to body orientation: two goals for muscle proprioceptive information processing? Exp Brain Res. 1999;124(1):80-8.
21. Bove M, Courtine G, Schieppati M. Neck muscle vibration and spatial orientation during stepping in place in humans. J Neurophysiol. 2002;88(5):2232-41.
22. Galm R, Rittmeister M, Schmitt E. Vertigo in patients with cervical spine dysfunction. Eur Spine J. 1998;7(1):55-8.
23. Wrisley DM, Sparto PJ, Whitney SL, Furman JM. Cervicogenic dizziness: a review of diagnosis and treatment. J Orthop Sports Phys Ther. 2000;30(12):755-66.
24. Treleaven J, Jull G, Lowchoy N. Standing balance in persistent whiplash: a comparison between subjects with and without dizziness. J Rehabil Med. 2005;37(4):224-9.
25. Kamouchi M, Kishikawa K, Matsuo R, Yasumori K, Inoue T, Okada Y, et al. Ultrasonographic detection of extracranial vertebral artery compression in bow hunter’s brain ischemia caused by neck rotation. Cerebrovasc Dis. 2003;16(3):303-5.
26. Galli J, Tartaglione T, Calo L, Ottaviani F. Os odontoideum in a patient with cervical vertigo: a case report. Am J Otolaryngol. 2001;22(5):371-3.
27. Haldeman S, Dagenais S. Cervicogenic headaches: a critical review. Spine J. 2001;1(1):31-46.
28. Machaly SA, Senna MK, Sadek AG. Vertigo is associated with advanced degenerative changes in patients with cervical spondylosis. Clin Rheumatol. 2011;30(12):1527-34.
29. Olszewski J, Majak J, Pietkiewicz P, Luszcz C, Repetowski M. The association between positional vertebral and basilar artery flow lesion and prevalence of vertigo in patients with cervical spondylosis. Otolaryngol Head Neck Surg. 2006;134(4):680-4.
30. Nagashima C. Surgical treatment of vertebral artery insufficiency caused by cervical spondylosis. J Neurosurg. 1970;32(5):512-21.
31. Sheehan S, Bauer RB, Meyer JS. Vertebral artery compression in cervical spondylosis: arteriographic demonstration during life of vertebral artery insufficiency due to rotation and extension of the neck. Neurology. 2003;10(11):968.
32. Foster CA, Jabbour P. Barré-Leiou syndrome and the problem of the obsolete eponym. Laryngol Otol. 2007;121(7):680-3.
33. Endo K, Ichimaru K, Shimura H, Imakiire A. Cervical vertigo after hair shampoo treatment at a hairdressing salon: a case report. Spine. 2000;25(5):632-4.
34. Heidenreich KD, Beaudoin K, White JA. Cervicogenic dizziness as a cause of vertigo while swimming: an unusual case report. Am J Otolaryngol. 2008;29(6):429-31.
35. Humphreys BK, Bolton J, Peterson C, Wood A. A Cross-Sectional Study of the association between pain and disability in neck pain patients with dizziness of suspected cervical origin. Journal of whiplash & related disorders. 2002;1(2):63-73.
36. Kristajansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009;39(5):364-77.
37. Treleaven J, Jull G, LowChoy N. Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. J Rehabil Med. 2005;37(4):219-23.
38. Oosterveld WJ, Kortschot HW, Kingma GG, De Jong HA, Saatci MR. Electronystagmographic findings following cervical whiplash injuries. Acta Otolaryngol. 1991;111(2):201-5.
39. Alund M, Ledin T, Odkvist L, Larsson SE. Dynamic posturography among patients with common neck disorders. A study of 15 cases with suspected cervical vertigo. J Vestib Res. 1993;3(4):383-9.
40. Norré ME, Forrez G, Stevens A, Beckers A. Cervical vertigo diagnosed by posturography? Preliminary report. Acta Otolaryngol Belg. 1987;41(4):574-81.
41. Taneja MK. Cervico-ocular reflex in cervical vertigo. Indian J Otol. 2011;17(2):51-3.
42. Norre ME. Cervical vertigo. Diagnosis and semiological problem with special emphasis upon "cervical nystagmus". Acta Otorhinolaryngol Belg. 1987;41(3):436-52.
43. Kamali B, Hajiabolhassan F, Fatahi J, Nasliesfahani E, Sarafzadeh J, Faghihzadeh S. Comparing the vestibular evoked myogenic potentials in patients with type Ι diabetes mellitus and normal people. Audiol. 2013;22(2):94-103.Farhadi R, Hajiabolhassan F, Akhlaghi M, Jalaie Sh,
44. Akbarian M. Vestibular evoked myogenic potentials in patients with inactive stage of systemic lupus erythematosus. Audiol. 2013;22(2):63-72.
45. Ruckenstein MJ, Shepard NT. Balance function testing: rational approach. Otolaryngol Clin North Am. 2000;33(3):507-18.
2. Poole E, Treleaven J, Jull G. The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther. 2008;13(4):317-24.
3. Yahia A, Ghroubi S, Jribi S, Mâlla J, Baklouti S, Ghorbel A, et al. Chronic neck pain and vertigo: is a true balance disorder present? Ann Phys Rehabil Med. 2009;52(7-8):556-67.
4. Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther. 2005;10(1):4-13.
5. Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134(9 Pt 2):823-32.
6. Schenk R, Coons LB, Bennett SE, Huijbregts PA. Cervicogenic dizziness: a case report illustrating orthopaedic manual and vestibular physical therapy comanagement. J Man Manip Ther. 2006;14(3):56-68.
7. Cote P, Mior SA, Fitz-Ritson D. Cervicogenic vertigo: a report of three cases. J Can Chiropr Assoc. 1991;35(2):89-94.
8. Ardiç FN, Topuz B, Kara CO. Impact of multiple etiology on dizziness handicap. Otol Neurotol. 2006;27(5):676-80.
9. Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Man Ther. 2008;13(4):357-66.
10. Ryan GM, Cope S. Cervical vertigo. Lancet. 1955;269(6905):1355-8.
11. Karlberg M, Magnusson M, Malmström EM, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Arch Phys Med Rehabil. 1996;77(9):874-82.
12. Clendaniel RA, Landel R. Non-vestibular diagnosis and imbalance: cervicogenic dizziness. In: Herdman S, editor. Vestibular rehabilitation. 3rd ed. Philadelphia: FA Davis Company; 2007. p. 467-83.
13. Corneil BD, Olivier E, Munoz DP. Neck muscle responses to stimulation of monkey superior colliculus. I. Topography and manipulation of stimulation parameters. J Neurophysiol. 2002;88(4):1980-99.
14. Reddy RS, Maiya GA, Rao SK. Proprioceptive reposition errors in subjects with cervical spondylosis. IJHSR. 2012;1(2):65-73.
15. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control--Part 2: case studies. Man Ther. 2008;13(3):266-75.
16. Mergner T, Siebold C, Schweigart G, Becker W. Human perception of horizontal trunk and head rotation in space during vestibular and neck stimulation. Exp Brain Res. 1991;85(2):389-404.
17. Kogler A, Lindfors J, Odkvist LM, Ledin T. Postural stability using different neck positions in normal subjects and patients with neck trauma. Acta Otolaryngol. 2000;120(2):151-5.
18. Dieterich M, Pollmann W, Pfaffenrath V. Cervicogenic headache: electronystagmography, perception of verticality and posturography in patients before and after C2-blockade. Cephalalgia. 1993;13(4):285-288.
19. Mckenna GJ, Peng GC, Zee DS. Neck muscle vibration alters visually perceived roll in normals. J Assoc Res Otolaryngol. 2004;5(1):25-31.
20. Kavounoudias A, Gilhodes JC, Roll R, Roll JP. From balance regulation to body orientation: two goals for muscle proprioceptive information processing? Exp Brain Res. 1999;124(1):80-8.
21. Bove M, Courtine G, Schieppati M. Neck muscle vibration and spatial orientation during stepping in place in humans. J Neurophysiol. 2002;88(5):2232-41.
22. Galm R, Rittmeister M, Schmitt E. Vertigo in patients with cervical spine dysfunction. Eur Spine J. 1998;7(1):55-8.
23. Wrisley DM, Sparto PJ, Whitney SL, Furman JM. Cervicogenic dizziness: a review of diagnosis and treatment. J Orthop Sports Phys Ther. 2000;30(12):755-66.
24. Treleaven J, Jull G, Lowchoy N. Standing balance in persistent whiplash: a comparison between subjects with and without dizziness. J Rehabil Med. 2005;37(4):224-9.
25. Kamouchi M, Kishikawa K, Matsuo R, Yasumori K, Inoue T, Okada Y, et al. Ultrasonographic detection of extracranial vertebral artery compression in bow hunter’s brain ischemia caused by neck rotation. Cerebrovasc Dis. 2003;16(3):303-5.
26. Galli J, Tartaglione T, Calo L, Ottaviani F. Os odontoideum in a patient with cervical vertigo: a case report. Am J Otolaryngol. 2001;22(5):371-3.
27. Haldeman S, Dagenais S. Cervicogenic headaches: a critical review. Spine J. 2001;1(1):31-46.
28. Machaly SA, Senna MK, Sadek AG. Vertigo is associated with advanced degenerative changes in patients with cervical spondylosis. Clin Rheumatol. 2011;30(12):1527-34.
29. Olszewski J, Majak J, Pietkiewicz P, Luszcz C, Repetowski M. The association between positional vertebral and basilar artery flow lesion and prevalence of vertigo in patients with cervical spondylosis. Otolaryngol Head Neck Surg. 2006;134(4):680-4.
30. Nagashima C. Surgical treatment of vertebral artery insufficiency caused by cervical spondylosis. J Neurosurg. 1970;32(5):512-21.
31. Sheehan S, Bauer RB, Meyer JS. Vertebral artery compression in cervical spondylosis: arteriographic demonstration during life of vertebral artery insufficiency due to rotation and extension of the neck. Neurology. 2003;10(11):968.
32. Foster CA, Jabbour P. Barré-Leiou syndrome and the problem of the obsolete eponym. Laryngol Otol. 2007;121(7):680-3.
33. Endo K, Ichimaru K, Shimura H, Imakiire A. Cervical vertigo after hair shampoo treatment at a hairdressing salon: a case report. Spine. 2000;25(5):632-4.
34. Heidenreich KD, Beaudoin K, White JA. Cervicogenic dizziness as a cause of vertigo while swimming: an unusual case report. Am J Otolaryngol. 2008;29(6):429-31.
35. Humphreys BK, Bolton J, Peterson C, Wood A. A Cross-Sectional Study of the association between pain and disability in neck pain patients with dizziness of suspected cervical origin. Journal of whiplash & related disorders. 2002;1(2):63-73.
36. Kristajansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009;39(5):364-77.
37. Treleaven J, Jull G, LowChoy N. Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. J Rehabil Med. 2005;37(4):219-23.
38. Oosterveld WJ, Kortschot HW, Kingma GG, De Jong HA, Saatci MR. Electronystagmographic findings following cervical whiplash injuries. Acta Otolaryngol. 1991;111(2):201-5.
39. Alund M, Ledin T, Odkvist L, Larsson SE. Dynamic posturography among patients with common neck disorders. A study of 15 cases with suspected cervical vertigo. J Vestib Res. 1993;3(4):383-9.
40. Norré ME, Forrez G, Stevens A, Beckers A. Cervical vertigo diagnosed by posturography? Preliminary report. Acta Otolaryngol Belg. 1987;41(4):574-81.
41. Taneja MK. Cervico-ocular reflex in cervical vertigo. Indian J Otol. 2011;17(2):51-3.
42. Norre ME. Cervical vertigo. Diagnosis and semiological problem with special emphasis upon "cervical nystagmus". Acta Otorhinolaryngol Belg. 1987;41(3):436-52.
43. Kamali B, Hajiabolhassan F, Fatahi J, Nasliesfahani E, Sarafzadeh J, Faghihzadeh S. Comparing the vestibular evoked myogenic potentials in patients with type Ι diabetes mellitus and normal people. Audiol. 2013;22(2):94-103.Farhadi R, Hajiabolhassan F, Akhlaghi M, Jalaie Sh,
44. Akbarian M. Vestibular evoked myogenic potentials in patients with inactive stage of systemic lupus erythematosus. Audiol. 2013;22(2):63-72.
45. Ruckenstein MJ, Shepard NT. Balance function testing: rational approach. Otolaryngol Clin North Am. 2000;33(3):507-18.
| Issue | Vol 22 No 3 (2013) | |
| Section | Review Article(s) | |
| Keywords | ||
| Cervical vertigo cervicogenic vertigo cervical headache neck pain manual therapy vestibular rehabilitation | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Tavanai E, Hajiabolhassan F. Cervicogenic vertigo: etiology, diagnosis and treatment. Aud Vestib Res. 2017;22(3):1-13.
