Symptoms in cervical vertigo

Abstract

Objective: To use a unique, 41-question survey to identify patient features distinguishing cervical vertigo from vestibular causes of vertigo and vestibular migraine.

Methods: In this study, a unique, 41-question survey was administered to 48 patients diagnosed with cervical vertigo (n = 16), migraine (n = 16), and vestibular vertigo (eg, unilateral vestibular paresis, Meniere's disease) (n = 16) to test the hypothesis that a set of distinct symptoms can characterize cervical vertigo. Responses between the three diagnostic groups were compared to identify questions which differentiated patients based on their symptoms.

Results: Eight questions were successful in differentiating vestibular vertigo from migraine and cervical vertigo. Symptoms endorsed by subjects with cervical vertigo overlapped substantially with subjects with well-established vestibular disturbances as well as symptoms of subjects with migraine. Twenty-seven percent of cervical vertigo subjects reported having true vertigo, 50% having headache, and 94% having neck pain.

Conclusion: Lacking knowledge of neck disturbance, the symptoms we elicited in our questionnaire suggest that cervical vertigo subjects may resemble migraine subjects who also have evidence of neck injury. Whether or not subjects with "cervical vertigo" also overlap with other diagnoses defined by a combination of symptoms and exclusion of objective findings such as chronic subjective dizziness and other variants of psychogenic dizziness remain to be established.

Level of evidence: IV.

Keywords: Cervical Vertigo; cervicogenic dizziness; migraine; neck injury; symptoms; vertigo.

Figure 1

Endorsement frequencies for symptoms that significantly differentiated cervical vertigo (From left to right and top to bottom, Questions #35, 22, 5, 10, 19, 8, 16, and 21, respectively)