Head/Neck

Cervicogenic Dizziness

Cervicogenic dizziness blog

Introduction

  • Defined as a sensation of altered orientation or disequilibrium associated with neck dysfunction.
  • More common in females and those with sitting jobs or sustained neck positions.

Pathophysiology

  • Results from a sensory mismatch between neck proprioceptive input and sensory input from the visual and vestibular systems.
  • Triggered by quick neck movements, reduced neck ROM, neck pain, and certain neck positions.

Clinical Presentation

  • Co-existing neck symptoms with gradual, episodic dizziness lasting minutes to hours.
  • Dizziness described as non-rotatory, with sensations of disorientation, lightheadedness, accompanied by neck pain, reduced neck ROM, and balance issues.

Examination

  • Cervicogenic dizziness is a diagnosis of exclusion, requiring other causes to be ruled out first.
  • Inspection may reveal forward head posture, shoulder protraction, and slouched posture.
  • Active examination includes measuring neck ROM, assessing joint position sense, and balance tests.
  • Passive examination involves palpation for tenderness and mobility assessment of the cervical and upper thoracic spine.
  • Strength and Endurance Testing includes cranio-cervical flexion test, deep neck flexor endurance test, and cervical extensor endurance test.
  • Dizziness-specific assessment tests like cervical torsion test, smooth pursuit neck torsion test, and others focus on postural balance and eye/head coordination.

Treatment

  • Treatment based on examination findings, including manual therapy for ROM restrictions.
  • Strengthening and endurance exercises for the upper cervical spine.
  • Sensorimotor training for errors in joint position sense, eye movement control, and postural balance.
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References

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