In this recent article by the Bárány Society, the concept of “Cervical Dizziness” was evaluated as part of a project on the International Classification of Vestibular Disorders.
Following a thorough review of the literature, six possible mechanisms were identified: disruption of somatosensory afferents, involvement of the trigeminal-autonomic system (whether or not associated with migraine), the neurovascular hypothesis (compression of the sympathetic plexus of the vertebral arteries) and carotid sinus syndrome as a trigger for syncope.
It was concluded that the existing studies do not allow for conclusions of high quality or reliability to be drawn; further studies on pathophysiology and treatment are therefore required, combining optimal methodology (double-blind, placebo-controlled trials) with a robust a priori hypothesis. Consequently, it is not currently possible to establish a link between imbalance/vertigo and cervical pathology, to define diagnostic criteria or to recommend treatment; further research is therefore essential.
Excluded from this category were injuries resulting from a whiplash mechanism (as cervical acceleration is necessarily accompanied by cephalic acceleration, meaning that the resulting symptoms can hardly be attributed solely to cervical pathology), and vascular vertigo (the extremely rare syndrome of transient occlusion of the vertebral arteries due to spondylotic pathology, triggered by cervical movements).
Text by Ana Inês Martins
