Dizziness of Cervical Origin
Cervicogenic vertigo (CV) remains a somewhat controversial diagnosis as some physicians do not recognize it as a clinical entity. Yet there is ample evidence to suggest altered afferent input from the neck can give rise to “altered orientation in space and disequilibrium” (1). Generally speaking any process that disrupts afferent input such as whiplash injury or cervical spondylosis can result in CV. Up to 58% of individuals with whiplash injury report dizziness (2).
(1) Wrisley DM, Sparto PJ, Whitney SL, Furman JM. Cervicogenic dizziness: a review of diagnosis and treatment. J Orthop Sports Phys Ther 2000; 30(12):755-766.; (2) Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther 2005; 10(1):4-13.
Clinical Reviews
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The diagnosis of cervicogenic vertigo has not been accepted universally within the healthcare community and others feel vertigo itself has been poorly defined in the literature. Rather than argue semantics, for the purpose of this paper, the term dizziness of cervical origin (DCO) will be used to describe what is commonly referred to as cervicogenic vertigo. It has been clearly established in the scientific literature that there is significant afferent input from the mechanoreceptors in the cervical spine and surrounding soft tissue and these afferent impulses play an important role in proprioception. It has been postulated that disturbed afferent input, due to injury, reduces joint position sense, an essential component of proprioception. Clinically, dizziness and light headedness are often seen in the physician’s office as a result of whiplash injury. Additionally these symptoms are a relatively common presenting complaint in the chiropractor’s office, regardless of etiology and, based on clinical evidence, respond well to spinal manipulation. For the purpose of this paper cervicogenic vertigo and DCO will be considered interchangeable terms and a valid clinical diagnosis.
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It is important for the physician to recognize vertigo/dizziness that may indicate a potentially life-threatening condition from a more benign condition. Although a discussion on vertigo in general is beyond the scope of this paper, an excellent review outlining proper steps to diagnosis can be found in an article by Labuguen in the American Family Physician.
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Only two interventions for the treatment of dizziness of cervical origin (DCO) have been explored in multiple studies. Information on interventions beyond proprioceptive-exercise training and manual therapy is sparse in the scientific literature.
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Medical Subject Heading (MeSH) Information
MeSH Term:
Vertigo
Scope Note:
An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1)
MeSH Synonyms:
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Vertigo
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Vertigo, Subjective
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Subjective Vertigo
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Spinning Sensation
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Sensation, Spinning
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Sensations, Spinning
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Spinning Sensations
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Vertigo, Peripheral
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Peripheral Vertigo
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Vertigo, Constant
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Constant Vertigo
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Vertigo, Intermittant
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Intermittant Vertigo
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Positional Vertigo
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Vertigo, Positional
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Vertigo, Brain Stem
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Brain Stem Vertigo
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Vertigo, Brainstem
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Brainstem Vertigo
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Brainstem Vertigos
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Vertigos, Brainstem
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Vertigo, Essential
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Essential Vertigo
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Vertigo, Paroxysmal
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Paroxysmal Vertigo
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Central Nervous System Origin Vertigo
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Vertigo, Central Origin
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Central Origin Vertigo
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Vertigo, Central Nervous System Origin
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blood
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cerebrospinal fluid
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chemically induced
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classification
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complications
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congenital
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diagnosis
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diet therapy
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history
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pathology
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physiology
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prevention and control
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psychology
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radiography
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radionuclide imaging
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rehabilitation
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surgery
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therapy
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ultrasonography
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veterinary
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virology
See Related MeSH Terms:
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