What is cervicogenic dizziness?
Cervicogenic dizziness is a type of dizziness that originates from the cervical spine, or neck. It is often associated with neck pain and is thought to be caused by abnormal sensory input from the cervical spine structures, including muscles, joints, and ligaments. This abnormal input can affect the vestibular system, leading to sensations of dizziness or imbalance.
Unlike typical dizziness or benign paroxysmal positional vertigo (BPPV), which are usually caused by issues within the inner ear, cervicogenic dizziness is linked to neck dysfunction. BPPV, for example, causes brief episodes of vertigo triggered by changes in head position, often accompanied by nystagmus (involuntary eye movement). In contrast, cervicogenic dizziness tends to be more persistent and is directly related to neck movement or sustained neck postures.
Cervicogenic dizziness often includes a sense of unsteadiness, lightheadedness, and imbalance, which are typically exacerbated by neck movements or specific head positions. Patients may also experience neck pain, headaches, and a limited range of motion in the neck. Other associated symptoms can include visual disturbances, nausea, and a general feeling of disorientation. These are the same symptoms that provocative tests try to replicate. Unlike BPPV, cervicogenic dizziness does not usually involve nystagmus (involuntary eye movements).
Cervicogenic dizziness can be caused by various conditions affecting the cervical spine, including whiplash injuries, cervical spondylosis, cervical myofascial pain syndrome, and degenerative disc disease. Trauma to the neck, such as from a car accident or sports injury, can also lead to cervicogenic dizziness. Additionally, poor posture, muscle tension, and repetitive neck strain can contribute to the development of this condition.
How to assess for cervicogenic dizziness
Assessing cervicogenic dizziness involves a comprehensive examination that includes various suggested clinical tests. Key assessments include:
- Gaze stability assessment
- Saccadic eye movement assessment
- Eye-head coordination assessment
- Postural stability assessment
- Joint position sense error assessment (also known as the cervical relocation test)
- Smooth pursuit neck torsion test
- Clinical cervical torsion test (also known as the cervical neck torsion test)
- Cervical flexion rotation test
These specific diagnostic tests help in differential diagnosis by isolating the cervical spine as the source of dizziness by evaluating different aspects of eye, head, and body movement and their coordination. A thorough assessment using these tests is needed for accurate clinical diagnosis of cervicogenic dizziness and differentiates it from other types of dizziness and issues.
