Cervicogenic dizziness is a controversial entity, but there is evidence to support dizziness and vestibular symptoms caused by neck disorders. It typically occurs in patients with a history of neck injury (e.g. whiplash), and degenerative cervical spinal disease. Cervicogenic dizziness is believed to be due to disturbances of proprioceptive input from neck muscle receptors [Devaraja, 2018]. Patients with cervicogenic dizziness usually describe dizziness when the head and neck assume certain positions (which can be confused with benign paroxysmal positional vertigo).

Diagnosis

A history of neck pain preceding the onset of dizziness is often present [Magnusson, 2016]. Patients have tender points on the neck, as well as pain radiation to the shoulders and head [Devaraja, 2018, Magnusson, 2016]. The dizziness is episodic, and can be triggered by neck movements [Devaraja, 2018]. In my experience, there is usually a specific neck movement that usually triggers the dizziness. Examination and vestibular testing in patients with cervicogenic dizziness is normal [Devaraja, 2018; Magnusson, 2016].

Treatment

  • The first line of treatment is neck therapy (a specialized form of physical therapy designed to address neck problems).
  • Dry needling of the neck muscles is often effective.
  • Neck massage therapy can be a useful measure in some patients
  • Surgical treatment for degenerative cervical disease can be considered in appropriate candidates.

References

Devaraja K. Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management. Eur Arch Otorhinolaryngol 2018;275:2421-2433

Magnusson M, Malmstrom EM. The conundrum of cervicogenic dizzinesss. Handb Clin Neurol 2016;137:365-369