Neurologia. 2012 Sep 13. [Epub ahead of print]
Sección de Neurootología,
Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI),
Buenos Aires, Argentina
Chicago Dizziness and Hearing,
Chicago, EE. UU
INTRODUCTION: Cervical vertigo is a controversial entity. While it was overemphasised in the past, it is overlooked nowadays, and it seems to combine elements of myth and reality. The purpose of this article is to review the most important aspects of this entity from a historical, pathophysiological, clinical, and therapeutic point of view. We also identify the main alternative diagnoses that led to it being recognised erroneously, and classify and organise the literature in order to review earlier articles which first described the disease.
DEVELOPMENT: Some entities previously defined as cervical vertigo have survived the test of time and may be found in the literature today. This is true of rotational vertebral artery syndrome, post-traumatic cervical vertigo, and cervicogenic proprioceptive vertigo. Others, such as cervical sympathetic syndrome (Barré-Lieou syndrome), have been discredited. We present a clinical variant known as subclinical vertebrobasilar insufficiency in a context of cervical osteoarticular changes.
CONCLUSIONS: Cervical vertigo has been a controversial entity for many years. Completing a clinical-pathophysiological assessment to explain the symptoms in a particular case proves to be the most reasonable bedside strategy, regardless of the name assigned to the disease in the end. At present, no complementary studies have demonstrated that the variant known as cervicogenic proprioceptive vertigo is an independent entity, and measuring its true impact is difficult. Once potentially severe causes of the symptoms have been ruled out, the most appropriate strategy seems to be use of manipulative and vestibular physical therapy.