Abstract
(1) Background: Cervical vertigo (CV) represents a controversial entity, with a prevalence ranging from reported high frequency to negation of CV existence. (2) Objectives: To assess the prevalence and cause of vertigo in patients with a manifest form of severe cervical spondylosis–degenerative cervical myelopathy (DCM) with special focus on CV. (3) Methods: The study included 38 DCM patients. The presence and character of vertigo were explored with a dedicated questionnaire. The cervical torsion test was used to verify the role of neck proprioceptors, and ultrasound examinations of vertebral arteries to assess the role of arteriosclerotic stenotic changes as hypothetical mechanisms of CV. All patients with vertigo underwent a detailed diagnostic work-up to investigate the cause of vertigo. (4) Results: Symptoms of vertigo were described by 18 patients (47%). Causes of vertigo included: orthostatic dizziness in eight (22%), hypertension in five (14%), benign paroxysmal positional vertigo in four (11%) and psychogenic dizziness in one patient (3%). No patient responded positively to the cervical torsion test or showed significant stenosis of vertebral arteries. (5) Conclusions: Despite the high prevalence of vertigo in patients with DCM, the aetiology in all cases could be attributed to causes outside cervical spine and related nerve structures, thus confirming the assumption that CV is over-diagnosed.
Highlights
Dizziness and vertigo are among the most common complaints that lead patients to visit a physician
The cervical torsion test was used to verify the role of neck proprioceptors, and ultrasound examinations of vertebral arteries to assess the role of arteriosclerotic stenotic changes as hypothetical mechanisms of Cervical vertigo (CV)
(5) Conclusions: Despite the high prevalence of vertigo in patients with degenerative cervical myelopathy (DCM), the aetiology in all cases could be attributed to causes outside cervical spine and related nerve structures, confirming the assumption that CV is over-diagnosed
Summary
Dizziness and vertigo are among the most common complaints that lead patients to visit a physician. Vertigo is not a single disease entity but a symptom of a wide range of diseases of varying aetiology. In an out-patient sample of 1000 patients visiting a general hospital in Japan with a chief complaint of dizziness, estimated a prevalence of CV as high as 90% [5]. These data are in striking contrast to the opinion of several leading experts in the field who doubt the diagnosis of CV entirely [6]
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