Cervicogenic Dizziness
Background:
Signs and symptoms of cervicogenic dizziness is often subjective reports from the patients. Patients may describe their symptoms by saying (Wrisley, 2000):
Diagnosis (Wrisley, 2000):
The diagnosis of cervicogenic dizziness is characterized by dizziness and disequilibrium that is associated with neck pain in patients with cervical pathology. Cervicogenic dizziness is a diagnosis of exclusion; it is based on the elimination of other competing diagnoses, such as vestibular or central nervous system pathologies. Since there is a lack of a definitive diagnostic tests, the diagnosis of cervicogenic dizziness is suggested by:
Treatment: (Wrisley, 2000)
Special Tests: (Wrisley, 2000)
- The occurrence of cerviocogenic dizziness is often associated with flexion-extension injuries, such as whiplash acquired in a motor vehicle accident. Cervicogenic dizziness typically occurs in episodes lasting minutes to hours and can be gradual and episodic in nature. The primary symptom of whiplash is neck pain, followed by headache, dizziness, vertigo, and disequilibrium (Wrisley, 2000).
Signs and symptoms of cervicogenic dizziness is often subjective reports from the patients. Patients may describe their symptoms by saying (Wrisley, 2000):
- "My neck hurts"
- "People tell me that my head is not straight."
- "I feel like I am going to fall and I can't walk straight."
- "I am having trouble reading and my vision is jumping."
- "I feel like everything is moving when I am in a busy environment with motion and distractions."
- "I have swimming sensations in my head."
Diagnosis (Wrisley, 2000):
The diagnosis of cervicogenic dizziness is characterized by dizziness and disequilibrium that is associated with neck pain in patients with cervical pathology. Cervicogenic dizziness is a diagnosis of exclusion; it is based on the elimination of other competing diagnoses, such as vestibular or central nervous system pathologies. Since there is a lack of a definitive diagnostic tests, the diagnosis of cervicogenic dizziness is suggested by:
- A close temporal relationship between neck pain and symptoms of dizziness, including time of onset and occurrence of episodes
- Previous neck injury or pathology
- Elimination of other causes of dizziness
Treatment: (Wrisley, 2000)
- Manual Therapy (mobilization and manipulation)
- Mechanical traction
- Physical modalities
- Postural re-education
- Active range of motion
- Massage
- Balance re-training
- Trigger point injection
- Muscle relaxants
- Use of a soft cervical collar during the acute phase
Special Tests: (Wrisley, 2000)
- Oculomotor screening: ENG records movements of the eyes
- Caloric testing: Horizontal canal testing occurs when warm or cold air or water is placed in the ear canal. ENG records movement of the eyes.
- Positional testing: In a dark room, the patient's head is turned to the right and left while eye movements are recorded in each position.
- Rotational testing: In a dark room, the patient is slowly moved to the right and the left in a rotating chair while eye movements are recorded in each position.
- Posturography: Force plates record the amount of sway a patient experiences.