cervicogenic dizziness

[dr_purvi]

hi there.... i need some material for a seminar on this topic... plz help

[stephandriver]

Dear Purvi,

Cervicogenic dizziness is a big word meaning very little. Basically the assumption here is that instead of the otoliths and canals of the middle ear malfunctioning and causing dizziness the cause is coming from some pathology/condition of the Cx.

Apart from Cx based neural connections to the central balance mechanism of the brain, of which I do not know of any evidence base, I would direct you to research the vertebrobasilar artery. Remebering your basic anatomy of this artery in the tranverse foramen of the cervical vertebrae, any undue compromise of this artery by pathology arising from structures in the cervical spine will cause reduced bloodflow directly to the brain. Hence the dizziness. Therefore find causes of compromise for your presentation ie osteophytic formation, discal lesions, instability especially C1-2 (alar ligament and transverse ligament testing).

Include in your presentation then the differential diagnosis between patholgy arising from the structures of the middle ear and the structures of the Cx. ie rotating the head keeping the shoulders fixated, then rotating the shoulders keeping the head fixated.

Neurology has never been my strong point, especially considering that it can be specualtive. But I am sure that if there exists central stenosis of the Cx then it is entirely possible that by performing sustained quadrant manouvres/Cx rotation and in doing so compromising the spinal cord this could cause some sort of reflex dizziness. Good luck researching this one though!

Finally in your presentation dont forget to cover the anatomy of the vertebrobasilar artery. Especially as it winds around the passage from the tranverse foramen at C1 then the occipital condyles and into the foramen magnum. Very tight and snaky little passage indeed. Mention how vulnerable it is at this site. The use of an articulated skeleton at this point would be very instructive to the class.

Hope this at least helps!

Cheers
Scooba.

[dr_purvi]

thanks so much for ur help....

[Fyzzio]

Have a look at this:

D.M. Wrisley et al
Cervicogenic dizziness: A review of diagnosis and treatment
J Orthop Sports Phys Ther - Volume 30 - Number 12 - December 2000

regards,
Fyzzio