Cervicogenic Dizziness

Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment

By Frank M. Painter|December 22, 2024|Cervicogenic Dizziness, Chiropractic Management|

Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment

SOURCE: J Clinical Medicine 2022 (Oct 26); 11 (21): 6293
Yongchao Li • Liang Yang • Chen Dai • Baogan Peng

The Third Medical Centre of Chinese PLA General Hospital,
Department of Orthopedics,
69 Yongding Road,
Beijing 100039, China.

FROM: J Orthop Sports Phys Ther 2009

Basic science and clinical evidence suggest that cervical spine disorders can lead to dizziness. The cervical spine has highly developed proprioceptive receptors, whose input information is integrated with the visual and vestibular systems in the central nervous system, acting on the neck and eye muscleThere are many more studiess to maintain the coordinative motion of the head, eyes, neck, and body through various reflex activities.

When the cervical proprioceptive input changes due to the mismatch or conflict between vestibular, visual, and proprioceptive inputs, cervicogenic dizziness may occur. The diagnosis of cervicogenic dizziness can be determined based on clinical features, diagnostic tests, and the exclusion of other possible sources of dizziness. The cervical torsion test appears to be the best diagnostic method for cervicogenic dizziness.

Based on the available evidence, we first developed the diagnostic criteria for cervicogenic dizziness. Treatment for cervicogenic dizziness is similar to that for neck pain, and manual therapy is most widely recommended.

Keywords: cervical proprioception; cervicogenic dizziness; diagnosis; management; neck pain; proprioceptors.

From the FULL TEXT Article:

Introduction

Dizziness is one of the most common reasons for consultation in adult patients. [1, 2] It is an umbrella term used to describe various sensations, including vertigo, disequilibrium, lightheadedness, or presyncope (Table 1). [2] From this perspective, vertigo is just one part of dizziness. However, in the light of the International Bárány Society for NeuroOtology [3], dizziness and vertigo are no longer subordinate but independent allelic symptoms. Dizziness and vertigo may coexist or occur sequentially (Table 2). [3] In 1955, Ryan and Cope [4] first described dizziness caused by neck disorders as cervical vertigo, also known as cervicogenic vertigo, cervicogenic dizziness or cervical dizziness. In this review, we use cervicogenic dizziness to name this trouble. A recent clinical observation of a large number of cases (1,000 cases) found that cervicogenic dizziness accounted for 89% of all dizziness, or vertigo. [5] Cervical spondylosis was one of the common causes of dizziness in the elderly in a community survey. [1] Among patients with cervical vertebral whiplash injuries, the prevalence of dizziness has been variously reported, ranging from 20% to 90%. [6] Nearly half of patients with neck pain have cervicogenic dizziness. [1] However, cervicogenic dizziness is the most controversial among all dizziness because its pathogenesis is unclear, and its diagnosis and treatment are difficult. [6-9]

Cervicogenic dizziness is considered to have four different pathogenesis, but proprioceptive cervicogenic dizziness is the most common and accepted by most scholars. [6] Unlike other forms of dizziness, cervicogenic dizziness is of interest not only to neurologists but also to physiotherapists, pain physicians, and orthopedic surgeons. The purpose of this narrative review is to highlight the pathophysiology, diagnosis, and treatment of cervicogenic dizziness from the perspective of the cervical proprioceptive afferent disorder.

There are more articles like this @

VERTIGO and/or BALANCE Section

(more…)

0

Conservative Management of Cervicogenic Dizziness Associated With Upper Cervical Instability and Postural Orthostatic Tachycardia Syndrome: A Case Report

By Frank M. Painter|December 9, 2024|Cervicogenic Dizziness, Chiropractic Care, Evidence-based Practice|

Conservative Management of Cervicogenic Dizziness Associated With Upper Cervical Instability and Postural Orthostatic Tachycardia Syndrome: A Case Report

The Chiro.Org Blog

SOURCE: Cureus 2024 (Oct 31); 16 (10): e72765

Robert J Trager • Andres Schuster • Cliff Tao • Gina Zamary

Connor Whole Health,
University Hospitals Cleveland Medical Center,
Cleveland, USA.

OPEN ACCESS

Cervicogenic dizziness (CGD) is a disorder in which dizziness arises from cervical spine dysfunction and is diagnosed after excluding other conditions. We present a case of a 27–year-old woman with a six-year history of dizziness, neck and cervicothoracic pain, and occipital-temporal-orbital headaches. The patient also experienced occasional severe, incapacitating episodes of dizziness with vomiting. Previous evaluations, including advanced imaging, had helped rule out central, otolithic, and psychogenic causes of dizziness. Dynamic radiographs revealed signs of lateral instability of C1 while tilt table testing revealed postural orthostatic tachycardia syndrome (POTS). Over eight months, the patient underwent a regimen of gentle manual therapies and cervical stability exercises. The patient’s dizziness substantially improved, as measured by the Dizziness Handicap Inventory (DHI), with scores reducing from 50 (moderate handicap) to 10 (less than mild handicap). This case highlights the importance of considering cervical spine dysfunction and associated conditions like POTS in the differential diagnosis of chronic dizziness. While conservative management including manual therapy appeared effective in this case for CGD with underlying upper cervical instability and POTS, additional research is needed on this topic.

Keywords: case reports; cervical vertebrae; chiropractic; dizziness; headache; joint instability; neck pain; postural orthostatic tachycardia syndrome; rehabilitation.

From the FULL TEXT Article:

Introduction

Dizziness is a non-specific term used to describe various sensations, including lightheadedness, unsteadiness, or a spinning feeling. Its utility as a diagnostic term is limited due to its broad nature, necessitating a thorough assessment of the patient’s history and examination for an accurate diagnosis. [1] Dizziness is typically evaluated based on its timing, associated triggers, and symptom subtypes. For instance, benign paroxysmal positional vertigo (BPPV), the most common cause of dizziness, accounting for approximately 24% of cases, presents with brief episodes of rotatory dizziness triggered by head movements. [1, 2] Other subtypes of dizziness may arise from vestibular, vascular, or psychogenic sources, with less frequent causes including Meniere’s disease, vestibular neuritis, and others. [2]

There are more articles like this @

VERTIGO and/or BALANCE Section

(more…)

0

Approach to Cervicogenic Dizziness: A Comprehensive Review of its Aetiopathology and Management

By Frank M. Painter|December 26, 2019|Cervicogenic Dizziness|

Approach to Cervicogenic Dizziness: A Comprehensive Review of its Aetiopathology and Management

The Chiro.Org Blog

SOURCE: Eur Arch Otorhinolaryngol. 2018 (Oct)

K. Devaraja

Department of Otorhinolaryngology,
Kasturba Medical College,
Manipal Academy of Higher Education,
Manipal, Udupi, Karnataka, 576104, India.

PURPOSE: Though there is abundant literature on cervicogenic dizziness with at least half a dozen of review articles, the condition remains to be enigmatic for clinicians dealing with the dizzy patients. However, most of these studies have studied the cervicogenic dizziness in general without separating the constitute conditions. Since the aetiopathological mechanism of dizziness varies between these cervicogenic causes, one cannot rely on the universal conclusions of these studies unless the constitute conditions of cervicogenic dizziness are separated and contrasted against each other.

METHODS: This narrative review of recent literature revisits the pathophysiology and the management guidelines of various conditions causing the cervicogenic dizziness, with an objective to formulate a practical algorithm that could be of clinical utility.

There are more articles like this @ our:

CHIROPRACTIC and VERTIGO and/or BALANCE Page

(more…)

0

Cervicogenic Dizziness

By Frank M. Painter|December 26, 2019|Cervicogenic Dizziness|

Cervicogenic Dizziness

The Chiro.Org Blog

SOURCE: Oxford Medical Case Reports 2019 (Dec 9)

Eric Chun Pu Chu, Wui Ling Chin, and Amiya Bhaumik

New York Chiropractic & Physiotherapy Center,
New York Medical Group

Cervical muscles have numerous connections with vestibular, visual and higher centres, and their interactions can produce effective proprioceptive input. Dysfunction of the cervical proprioception because of various neck problems can alter orientation in space and cause a sensation of disequilibrium. Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain in patients with cervical pathology. Here, we report a 24–year-old female, who was diagnosed with CGD based on the correlating episodes of neck pain and dizziness. Both symptoms improved with targeted chiropractic adjustment and ultrasound therapy. CGD is a seemingly simple complaint for patients, but tends to be a controversial diagnosis because there are no specific tests to confirm its causality. For CGD to be considered, an appropriate management for the neck pain should not be denied any patient.

KEYWORDS: cervical proprioception; cervicogenic dizziness; chiropractic adjustment; neck pain

There are more articles like this @ our:

CHIROPRACTIC and VERTIGO and/or BALANCE Page

(more…)

0