Review of cervical vertigo
Abstract Introduction and objective: Currently remains the debate on cervical origin dizziness. In this narrative review, we outline the pathophysiological mechanism that attempt to explain this syndrome to understand its clinical manifestations and facilitate the diagnostic and therapeutic orientation of patients. Method: narrative review. Results: We will consider that a patient with neck pain and dizziness/imbalance has vertigo cervical, if other causes have been eliminated (neurological, vestibular, psychosomatic) and, above all, if responding to the cervical physiotherapy with reducing pain and dizziness. Depending on your medical history, will focus the explorations towards the study of the blood flow of the vertebral arteries, oculomotor findings, postural control and observation of the cervical kinesthesia sense. Discussion: The controversy over cervicogenic dizziness is due in large part to the lack of a specific laboratory test confirming the diagnosis to us. Conclusions: Before a patient with suspected symptoms of cervical vertigo and once discarded other causes, we will initiate a treatment, even if we ignore the underlying mechanisms.
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Barnes GR, Forbat LN. Cervical and vestibular afferent control of oculomotor response in man. Acta Otolaryngol. 1979;88(1-2):79-87. https://doi.org/10.3109/00016487909137143 / PMid:474124
Barré MJA. Sur un syndrome sympathique cervical posterieur er sa cause frequente: L'arthrite cervicale. Rev Neurol(Paris). 1926;45:1246-8.
Bartual Pastor J, Bartual-Magro J. Vértigo cervical. En: Bartual-Pastor J, Pérez-Fernández N. El sistema vestibular y sus alteraciones. Masson, S.A. 1ª Ed. 1999. Tomo II. Patología. Cap. 37; pp. 449-457.
Bianco A, Pomara F, Petrucci M, Battaglia G, Filingeri D, Bellafiore M, et al. Postural stability in subjects with whiplash injury symptoms: results of a pilot study. Acta Otolaryngol. 2014;134(9):947-51. PMID: 25012056. / https://doi.org/10.3109/00016489.2014.906749
Brandt T, Bronstein AM. Cervical vertigo. J Neurol Neurosurg Psychiatry. 2001;71(1):8-12. https://doi.org/10.1136/jnnp.71.1.8 / PMid:11413255 PMCid:PMC1737478
Caplan LR, Wityk RJ, Glass TA, Tapia J, Pazdera L, Chang HM, et al. New England Medical Center Posterior Circulation registry. Ann Neurol. 2004;56(3):389-98. https://doi.org/10.1002/ana.20204 / PMid:15349866
Clendaniel RA, Landel R. Physical therapy management of cervicogenic dizziness. En: Herdman SJ, Clendaniel RA: Vestibular Rehabilitation. F.A. Davis Company. 4ª Ed. 2014. Cap. 31; pp. 590-609.
Cornelius JF, George B, N'dri Oka D, Spiriev T, Steiger HJ, Hänggi D. Bow-hunter's syndrome caused by dynamic vertebral artery stenosis at the cranio-cervical junction--a management algorithm based on a systematic review and a clinical series. Neurosurg Rev. 2012;35(1):127-35; discussion 135. PMID: 21789571. / https://doi.org/10.1007/s10143-011-0343-4
de Jong PT, de Jong JM, Cohen B, Jongkees LB. Ataxia and nystagmus induced by injection of local anesthetics in the Neck. Ann Neurol. 1977 Mar;1(3):240-6. https://doi.org/10.1002/ana.410010307 / PMid:407834
Foster CA, Jabbour P. Barré-Lieou syndrome and the problem of the obsolete eponym. J Laryngol Otol. 2007;121(7):680-3. https://doi.org/10.1017/S002221510600346X / PMid:17052362
Grant R. Vertebral artery testing - the Australian Physiotherapy Association Protocol after 6 years. Man Ther. 1996;1(3):149-153. https://doi.org/10.1054/math.1996.0264 / PMid:11440503
Hain TC. Cervicogenic causes of vertigo. Curr Opin Neurol. 2015;28(1):69-73. PMID: 25502050. / https://doi.org/10.1097/WCO.0000000000000161
Hohl M. Soft tissue injuries of the neck. Clin Orthop Relat Res. 1975;(109):42-9. https://doi.org/10.1097/00003086-197506000-00006 / PMid:1132204
Humphreys BK, Peterson C. Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up. Chiropr Man Therap. 2013. 7;21(1):3. PMID: 23295018. / https://doi.org/10.1186/2045-709X-21-3
Huygen PL, Verhagen WI, Nicolasen MG. Cervico-ocular reflex enhancement in labyrinthine-defective and normal subjects. Exp Brain Res. 1991;87(2):457-64. https://doi.org/10.1007/BF00231863 / PMid:1769396
Jansen GB, Edlund C, Grane P, Hildingsson C, Karlberg M, Link H, et al.; Swedish Society of Medicine; Whiplash Commission Medical Task Force. Whiplash injuries: diagnosis and early management. The Swedish Society of Medicine and the Whiplash Commission Medical Task Force. Eur Spine J. 2008;17 Suppl 3:S355-417. PMID: 18820955. / https://doi.org/10.1007/s00586-008-0767-x
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. PMID: 8822677. / https://doi.org/10.1016/S0003-9993(96)90273-7
Karlberg M, Magnusson M. Asymmetric optokinetic after-nystagmus induced by active or passive sustained head rotations. Acta Otolaryngol. 1996;116(5):647-51. PMID: 8908238. / https://doi.org/10.3109/00016489609137903
Kasch H, Bach FW, Jensen TS. Handicap after acute whiplash injury: a 1-year prospective study of risk factors. Neurology. 2001. 26;56(12):1637-43. PMID: 11425927.
Kristjansson 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. doi: 10.2519/jospt.2009.2834. PMID: 19411769. / https://doi.org/10.2519/jospt.2009.2834
Lee JD, Park MK, Lee BD, Park JY, Lee TK, Sung KB. Otolith function in patients with head trauma. Eur Arch Otorhinolaryngol. 2011;268(10):1427-30. doi: 10.1007/s00405-010-1426-5. PMID: 21328005. / https://doi.org/10.1007/s00405-010-1426-5
L'Heureux-Lebeau B, Godbout A, Berbiche D, Saliba I. Evaluation of paraclinical tests in the diagnosis of cervicogenic dizziness. Otol Neurotol. 2014;35(10):1858-65. PMID: 25058834. / https://doi.org/10.1097/MAO.0000000000000506
Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2015;18(4):E583-95. Review. PMID: 26218949.
Lu DC, Zador Z, Mummaneni PV, Lawton MT. Rotational vertebral artery occlusion-series of 9 cases. Neurosurgery. 2010;67(4):1066-72; discussion 1072. PMID: 20881570. / https://doi.org/10.1227/NEU.0b013e3181ee36db
Lystad RP, Bell G, Bonnevie-Svendsen M, Carter CV. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropr Man Therap. 2011. 18;19(1):21. PMID: 21923933. / https://doi.org/10.1186/2045-709X-19-21
Magnusson M, Malmström EM. The conundrum of cervicogenic dizziness. Handb Clin Neurol. 2016;137:365-9. PMID: 27638084. / https://doi.org/10.1016/B978-0-444-63437-5.00026-1
Mitchell J. Vertebral Artery Blood flow Velocity Changes Associated with Cervical Spine rotation: A Meta-Analysis of the Evidence with implications for Professional Practice. J Man Manip Ther. 2009;17(1):46-57. PMID: 20046565. / https://doi.org/10.1179/106698109790818160 / PMCid:PMC2704344
Philipszoon AJ, Bos JH. Neck torsion nystagmus. Pract Otorhinolaryngol (Basel). 1963;25:339-44. PMID: 14059771. https://doi.org/10.1159/000274540
Racicki S, Gerwin S, Diclaudio S, Reinmann S, Donaldson M. Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. J Man Manip Ther. 2013;21(2):113-24. doi: 10.1179/2042618612Y.0000000025. PMID: 24421621. https://doi.org/10.1179/2042618612Y.0000000025
Reid SA, Callister R, Snodgrass SJ, Katekar MG, Rivett DA. Manual therapy for cervicogenic dizziness: Long-term outcomes of a randomised trial. Man Ther. 2015;20(1):148-56. PMID: 25220110. / https://doi.org/10.1016/j.math.2014.08.003
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. PMID: 17951095. / https://doi.org/10.1016/j.math.2007.03.006
Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther. 2005;10(1):4-13. Review. PMID: 15681263.
Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994;75(8):895-9. PMID: 8053797. / https://doi.org/10.1016/0003-9993(94)90115-5
Ryan GM, Cope S. Cervical vertigo. Lancet. 1955.31;269(6905):1355-8. PMID: 13279136.
Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med. 2005. 23;352(25):2618-26. Review. PMID: 15972868.
Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med. 2001. 22;344(12):898-906. Review. PMID: 11259724.
Sorensen BF. Bow hunter's stroke. Neurosurgery. 1978;2(3):259-61. https://doi.org/10.1227/00006123-197805000-00013 / PMid:732978
Sterling M. A proposed new classification system for whiplash associated disorders--implications for assessment and management. Man Ther. 2004;9(2):60-70. Review. PMID: 15040964.
Tjell C, Rosenhall U. Smooth pursuit neck torsion test: a specific test for cervical dizziness. Am J Otol. 1998;19(1):76-81. PMID: 9455954.
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. PMID: 16024477.
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. PMID: 16024478. / https://doi.org/10.1080/16501970510027989
Weintraub MI. Beauty parlor stroke syndrome: report of five cases. JAMA. 1993. 28;269(16):2085-6. PMID: 8468755.
Williams D, Wilson TG. The diagnosis of the major and minor syndromes of basilar insufficiency. Brain. 1962;85:741-74. PMID: 14000840. / https://doi.org/10.1093/brain/85.4.741
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. Review. PMID: 11153554.
Yacovino DA, Hain TC. Clinical characteristics of cervicogenic-related dizziness and vertigo. Semin Neurol. 2013;33(3):244-55. PMID: 24057828. / https://doi.org/10.1055/s-0033-1354592
Yacovino DA. Cervical vertigo: Myths, facts, and scientific evidence. Neurologia 2012; 13:211-3. PMID: 22981375. / https://doi.org/10.1016/j.nrl.2012.06.013
Barré MJA. Sur un syndrome sympathique cervical posterieur er sa cause frequente: L'arthrite cervicale. Rev Neurol(Paris). 1926;45:1246-8.
Bartual Pastor J, Bartual-Magro J. Vértigo cervical. En: Bartual-Pastor J, Pérez-Fernández N. El sistema vestibular y sus alteraciones. Masson, S.A. 1ª Ed. 1999. Tomo II. Patología. Cap. 37; pp. 449-457.
Bianco A, Pomara F, Petrucci M, Battaglia G, Filingeri D, Bellafiore M, et al. Postural stability in subjects with whiplash injury symptoms: results of a pilot study. Acta Otolaryngol. 2014;134(9):947-51. PMID: 25012056. / https://doi.org/10.3109/00016489.2014.906749
Brandt T, Bronstein AM. Cervical vertigo. J Neurol Neurosurg Psychiatry. 2001;71(1):8-12. https://doi.org/10.1136/jnnp.71.1.8 / PMid:11413255 PMCid:PMC1737478
Caplan LR, Wityk RJ, Glass TA, Tapia J, Pazdera L, Chang HM, et al. New England Medical Center Posterior Circulation registry. Ann Neurol. 2004;56(3):389-98. https://doi.org/10.1002/ana.20204 / PMid:15349866
Clendaniel RA, Landel R. Physical therapy management of cervicogenic dizziness. En: Herdman SJ, Clendaniel RA: Vestibular Rehabilitation. F.A. Davis Company. 4ª Ed. 2014. Cap. 31; pp. 590-609.
Cornelius JF, George B, N'dri Oka D, Spiriev T, Steiger HJ, Hänggi D. Bow-hunter's syndrome caused by dynamic vertebral artery stenosis at the cranio-cervical junction--a management algorithm based on a systematic review and a clinical series. Neurosurg Rev. 2012;35(1):127-35; discussion 135. PMID: 21789571. / https://doi.org/10.1007/s10143-011-0343-4
de Jong PT, de Jong JM, Cohen B, Jongkees LB. Ataxia and nystagmus induced by injection of local anesthetics in the Neck. Ann Neurol. 1977 Mar;1(3):240-6. https://doi.org/10.1002/ana.410010307 / PMid:407834
Foster CA, Jabbour P. Barré-Lieou syndrome and the problem of the obsolete eponym. J Laryngol Otol. 2007;121(7):680-3. https://doi.org/10.1017/S002221510600346X / PMid:17052362
Grant R. Vertebral artery testing - the Australian Physiotherapy Association Protocol after 6 years. Man Ther. 1996;1(3):149-153. https://doi.org/10.1054/math.1996.0264 / PMid:11440503
Hain TC. Cervicogenic causes of vertigo. Curr Opin Neurol. 2015;28(1):69-73. PMID: 25502050. / https://doi.org/10.1097/WCO.0000000000000161
Hohl M. Soft tissue injuries of the neck. Clin Orthop Relat Res. 1975;(109):42-9. https://doi.org/10.1097/00003086-197506000-00006 / PMid:1132204
Humphreys BK, Peterson C. Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up. Chiropr Man Therap. 2013. 7;21(1):3. PMID: 23295018. / https://doi.org/10.1186/2045-709X-21-3
Huygen PL, Verhagen WI, Nicolasen MG. Cervico-ocular reflex enhancement in labyrinthine-defective and normal subjects. Exp Brain Res. 1991;87(2):457-64. https://doi.org/10.1007/BF00231863 / PMid:1769396
Jansen GB, Edlund C, Grane P, Hildingsson C, Karlberg M, Link H, et al.; Swedish Society of Medicine; Whiplash Commission Medical Task Force. Whiplash injuries: diagnosis and early management. The Swedish Society of Medicine and the Whiplash Commission Medical Task Force. Eur Spine J. 2008;17 Suppl 3:S355-417. PMID: 18820955. / https://doi.org/10.1007/s00586-008-0767-x
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. PMID: 8822677. / https://doi.org/10.1016/S0003-9993(96)90273-7
Karlberg M, Magnusson M. Asymmetric optokinetic after-nystagmus induced by active or passive sustained head rotations. Acta Otolaryngol. 1996;116(5):647-51. PMID: 8908238. / https://doi.org/10.3109/00016489609137903
Kasch H, Bach FW, Jensen TS. Handicap after acute whiplash injury: a 1-year prospective study of risk factors. Neurology. 2001. 26;56(12):1637-43. PMID: 11425927.
Kristjansson 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. doi: 10.2519/jospt.2009.2834. PMID: 19411769. / https://doi.org/10.2519/jospt.2009.2834
Lee JD, Park MK, Lee BD, Park JY, Lee TK, Sung KB. Otolith function in patients with head trauma. Eur Arch Otorhinolaryngol. 2011;268(10):1427-30. doi: 10.1007/s00405-010-1426-5. PMID: 21328005. / https://doi.org/10.1007/s00405-010-1426-5
L'Heureux-Lebeau B, Godbout A, Berbiche D, Saliba I. Evaluation of paraclinical tests in the diagnosis of cervicogenic dizziness. Otol Neurotol. 2014;35(10):1858-65. PMID: 25058834. / https://doi.org/10.1097/MAO.0000000000000506
Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2015;18(4):E583-95. Review. PMID: 26218949.
Lu DC, Zador Z, Mummaneni PV, Lawton MT. Rotational vertebral artery occlusion-series of 9 cases. Neurosurgery. 2010;67(4):1066-72; discussion 1072. PMID: 20881570. / https://doi.org/10.1227/NEU.0b013e3181ee36db
Lystad RP, Bell G, Bonnevie-Svendsen M, Carter CV. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropr Man Therap. 2011. 18;19(1):21. PMID: 21923933. / https://doi.org/10.1186/2045-709X-19-21
Magnusson M, Malmström EM. The conundrum of cervicogenic dizziness. Handb Clin Neurol. 2016;137:365-9. PMID: 27638084. / https://doi.org/10.1016/B978-0-444-63437-5.00026-1
Mitchell J. Vertebral Artery Blood flow Velocity Changes Associated with Cervical Spine rotation: A Meta-Analysis of the Evidence with implications for Professional Practice. J Man Manip Ther. 2009;17(1):46-57. PMID: 20046565. / https://doi.org/10.1179/106698109790818160 / PMCid:PMC2704344
Philipszoon AJ, Bos JH. Neck torsion nystagmus. Pract Otorhinolaryngol (Basel). 1963;25:339-44. PMID: 14059771. https://doi.org/10.1159/000274540
Racicki S, Gerwin S, Diclaudio S, Reinmann S, Donaldson M. Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. J Man Manip Ther. 2013;21(2):113-24. doi: 10.1179/2042618612Y.0000000025. PMID: 24421621. https://doi.org/10.1179/2042618612Y.0000000025
Reid SA, Callister R, Snodgrass SJ, Katekar MG, Rivett DA. Manual therapy for cervicogenic dizziness: Long-term outcomes of a randomised trial. Man Ther. 2015;20(1):148-56. PMID: 25220110. / https://doi.org/10.1016/j.math.2014.08.003
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. PMID: 17951095. / https://doi.org/10.1016/j.math.2007.03.006
Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther. 2005;10(1):4-13. Review. PMID: 15681263.
Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994;75(8):895-9. PMID: 8053797. / https://doi.org/10.1016/0003-9993(94)90115-5
Ryan GM, Cope S. Cervical vertigo. Lancet. 1955.31;269(6905):1355-8. PMID: 13279136.
Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med. 2005. 23;352(25):2618-26. Review. PMID: 15972868.
Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med. 2001. 22;344(12):898-906. Review. PMID: 11259724.
Sorensen BF. Bow hunter's stroke. Neurosurgery. 1978;2(3):259-61. https://doi.org/10.1227/00006123-197805000-00013 / PMid:732978
Sterling M. A proposed new classification system for whiplash associated disorders--implications for assessment and management. Man Ther. 2004;9(2):60-70. Review. PMID: 15040964.
Tjell C, Rosenhall U. Smooth pursuit neck torsion test: a specific test for cervical dizziness. Am J Otol. 1998;19(1):76-81. PMID: 9455954.
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. PMID: 16024477.
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. PMID: 16024478. / https://doi.org/10.1080/16501970510027989
Weintraub MI. Beauty parlor stroke syndrome: report of five cases. JAMA. 1993. 28;269(16):2085-6. PMID: 8468755.
Williams D, Wilson TG. The diagnosis of the major and minor syndromes of basilar insufficiency. Brain. 1962;85:741-74. PMID: 14000840. / https://doi.org/10.1093/brain/85.4.741
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. Review. PMID: 11153554.
Yacovino DA, Hain TC. Clinical characteristics of cervicogenic-related dizziness and vertigo. Semin Neurol. 2013;33(3):244-55. PMID: 24057828. / https://doi.org/10.1055/s-0033-1354592
Yacovino DA. Cervical vertigo: Myths, facts, and scientific evidence. Neurologia 2012; 13:211-3. PMID: 22981375. / https://doi.org/10.1016/j.nrl.2012.06.013
Valda-Rodrigo, J., Benito-Orejas, J. I., & Alonso-vielba-varea, J. (2017). Review of cervical vertigo. Revista ORL, 9(2), 97–104. https://doi.org/10.14201/orl.17191
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