Vestibular vertigo in emergency neurology and cervical osteochondrosis

Abstract

The paper deals with the study of reasons for urgent neurological hospitalization for vestibular vertigo and a role of cervical osteochondrosis in the development of vestibular disorders. A subgroup of 109 patients (84 women and 25 men) who had isolated vestibular vertigo (without other symptoms of nervous system lesion) was identified among 230 patients with acute systemic dizziness, nausea, vomiting with the referral diagnosis of «cervical osteochondrosis, vertebral artery syndrome», or «acute vertebrobasilar circulatory attack». The patients underwent a standard neurological examination, brain magnetic resonance imaging, an otorhinolaryngologist's advice with otoscopy, cervical spine X-ray in two interperpendicular (frontal and lateral) projections, and functional spondylography (flexion, extension). Meticulous manual examination was made in all the patients to verify reflex muscle and myofascial pain syndromes as a cause of vertebral artery irritation during an exacerbation of cervical osteochondrosis. The «cerebral» level of vestibular disorders could be excluded in most (82.3%) patients. The latter had acute peripheral vestibular pathology that required cerebral stroke or hemorrhage to be ruled out according to clinical data in most cases. Intermittent, recurrent, short-term vestibular crisis in the examined group of patients is temporarily or clinically unrelated to an exacerbation of cervical osteochondrosis.