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Cervicogenic Dizziness in an 11-Year-Old Girl:
A Case Report
Adolesc Health Med Ther 2021 (Nov 26); 12: 111116 ~ FULL TEXT
Cervicogenic dizziness (CGD) is a syndrome of neck pain accompanied by a false sensation of unsteadiness and dizziness due to neck pathology. An 11-year-old girl presented with neck pain and dizziness for four months. According to the patient's statement, her complaints were likely related to the prolonged smartphone use for texting. Sagittal radiograph showed cervical kyphosis, anterior wedging of several vertebrae, and mild anterolisthesis of C2 on C3 and C3 on C4. These findings might be present in as physiological variants in children. However, continuous static stress in the minor variants could aggravate biomechanical problems, such as cervicogenic dizziness. After ruling out other neurological or vestibular problems, a multicomponent approach consisted of thermal ultrasound therapy, cervical manipulation, and intermittent motorized cervicothoracic traction to release cervical complaints. Three months later, the patient reported a resolution of neck pain and dizziness. At 12-month follow-up, all radiographic metrics showed improvement, including restoration of cervical alignment and lordotic curvature. The immature growing cervical spine has unique anatomic, physiologic and biomechanical features. A static neck flexion can lead to typical injury patterns seen in this age group. This article aims to raise awareness of the potential harms of excessive smartphone use by children.
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Chiropractic Treatment of Older Adults with Neck Pain
with or without Headache or Dizziness: Analysis of
288 Australian Chiropractors' Self-reported Views
Chiropractic & Manual Therapies 2019 (Dec 18); 27: 65 ~ FULL TEXT
This is the first known study to investigate chiropractic care of older adults living with neck pain. The findings suggest that chiropractors use well-established manual and physical therapy techniques to manage neck pain in older adults. The favourable outcomes reported by participants highlight a potential role for using non-pharmacological multimodal therapeutic approaches for the management of neck pain in older adults. The findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Understanding the patients motivation for using multiple services may shed light on the health care needs of this population. Further research should also explore how chiropractic treatment of neck pain in older adults impacts patient experience, and other patient-reported outcomes. Given the high prevalence of neck pain in older people, the evidence for the effectiveness of manual and physical treatments for neck pain, the reported demand for chiropractic care in this population, the barriers to pain relief, and concerns among older adults regarding polypharmacy, further studies are needed to provide a more solid evidence-base upon which clinical guidelines for chiropractic management and/or co-management of this condition can be developed. Until then, we recommend that the current clinical guidelines be followed.
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Cervicogenic Dizziness
Oxford Medical Case Reports 2019 (Dec 9); 2019 (11): 476478 ~ FULL TEXT
Results from clinical studies [36] do show promise for the use of manual approaches in the treatment of Cervicogenic dizziness (CGD). The underlying mechanism for the efficacy of manual therapy includes stimulation of cervical proprioceptors and normalization of the afferent input. [14] It must be emphasized that manual therapies should be applied with great caution in patients with CGD. Ruling out neurovascular aetiologies is of utmost importance before starting the manual therapy to prevent any untoward events in CGD.
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Approach to Cervicogenic Dizziness:
A Comprehensive Review of its Aetiopathology and Management
Eur Arch Otorhinolaryngol. 2018 (Oct); 275 (10): 24212433 ~ FULL TEXT
In this narrative review, the various conditions causing cervicogenic dizziness have been discussed systematically, incorporating and segregating the existing literature as per the different categories. The classification of cervicogenic dizziness described is simple yet practical. The algorithm provided here for evaluating the suspected cases of cervicogenic dizziness seems appropriate and sensible. Nevertheless, since the algorithm is based on the extrapolation of facts from the literature, it needs further validation by clinical studies. Moreover, in some patients, dizziness could be due to a combination of cervicogenic cause and vestibular or neural deficits, the scenario which has been not addressed in the given algorithm.
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Chiropractic Treatment Including Instrument-assisted
Manipulation for Non-specific Dizziness and
Neck Pain in Community-dwelling Older People:
A Feasibility Randomised Sham-controlled Trial
Chiropractic & Manual Therapies 2018 (May 10); 26: 14
Recruitment of participants in this setting was difficult and expensive. However, a larger trial may be feasible at a specialised dizziness clinic within a rehabilitation setting. Compliance was acceptable and the outcome measures used were well accepted and responsive.
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The Role of Chiropractic Care in the Treatment of Dizziness
or Balance Disorders: Analysis of National Health
Interview Survey Data
J Evid Based Complementary Altern Med. 2016 (Apr); 21 (2): 138142
The odds ratio for perceiving being helped by a chiropractor was 4.36 (95% CI, 1.17-16.31) for respondents aged 65 years or older; 9.5 (95% CI, 7.92-11.40) for respondents reporting head or neck trauma; and 13.78 (95% CI, 5.59-33.99) for those reporting neurological or muscular conditions as the cause of their balance or dizziness.
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Is There a Role for Neck Manipulation in Elderly Falls Prevention?
An Overview
J Can Chiropr Assoc. 2015 (Mar); 59 (1): 5363 ~ FULL TEXT
We conclude that chiropractors may have a role in falls prevention strategies in the subpopulation of the elderly that suffer from mechanical neck pain or dysfunction and non-specific dizziness. However, this role remains to be rigorously studied and properly defined.
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Chiropractic Management of Benign Paroxysmal Positional
Vertigo Using the Epley Maneuver: A Case Series
J Manipulative Physiol Ther. 2013 (Feb); 36 (2): 119126 ~ FULL TEXT
The patients underwent one or more canalith repositioning procedures (Epley maneuver). Scores in each of the categories decreased from the initial to 6-day assessment and then again at the 30-day assessment. The effects of the treatment on the Short Form 12 scores showed changes between the initial assessment and 30 days posttreatment. The patients in this case series demonstrated reduction in symptoms with chiropractic management.
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Comparison of Outcomes in Neck Pain Patients With and Without
Dizziness Undergoing Chiropractic Treatment:
A Prospective Cohort Study With 6 month Follow-up
Chiropractic & Manual Therapies 2013 (Jan 7); 21: 3 ~ FULL TEXT
Neck pain patients with dizziness reported significantly higher pain and disability scores at baseline compared to patients without dizziness. A high proportion of patients in both groups reported clinically relevant improvement on the PGIC scale. At 6 months after start of chiropractic treatment there were no differences in any outcome measures between the two groups.
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Manual Therapy With and Without Vestibular Rehabilitation
for Cervicogenic Dizziness: A Systematic Review
Chiropractic & Manual Therapies 2011 (Sep 18); 19: 21 ~ FULL TEXT
There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended.
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Chiropractic Management of a 40-year-old Female
Patient With Mιniθre Disease
J Chiropractic Medicine 2010 (Mar); 9 (1): 2227 ~ FULL TEXT
Treatment included primarily high-velocity, low-amplitude spinal manipulation to the upper cervical and thoracic spine, along with soft-tissue trigger-point therapy, and stretching exercises. Within 2 weeks of treatment, the patient's tinnitus had resolved; and all other symptoms (including vertigo) were improved. The patient's headaches, neck pain, and vertigo were subsequently resolved within 3 months of treatment. The patient experienced only 2 minor episodes of self-resolving "light-headedness" over that time. After 2½ years of follow-up, any occasional episodes of mild aural fullness and/or light-headedness are either self-resolving or relieved with cervical spinal manipulation and soft-tissue treatment.
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Improvement in Ataxia, Dizziness, & Visual Disturbance, in a Child with
Vertebral Subluxations Undergoing Chiropractic Care:
A Case Study
J. Pediatric, Maternal & Family Health 2010; 2: 8994
The patient is an 11-year-old female who had a one month history of dizziness, fuzzy vision, and inability to stand or walk unassisted. MRI revealed an anatomical variant in which the patients cerebellar tonsils protruded 2mm into the foramen magnum, and there was compression of the pituitary gland by cerebral spinal fluid (CSF). The patient was no longer able to attend school, or perform normal daily activities of an eleven year-old. Physical exam findings indicated the presence of vertebral subluxation at the atlas and occiput. Specific manual and drop table assisted adjustments were performed, primarily in the upper cervical region, based on evidence of subluxation. The patient responded well to care with complete resolution of cerebellar symptoms.
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Observation of Curative Effect on Fixed-point Spin
Reduction of Spinal Manipulation Therapy for Cervical Vertigo
Zhongguo Gu Shang. 2010 (Feb); 23 (2): 99101
Fixed-point spin reduction of spinal manipulation therapy for cervical vertigo can accurately correct single or multiple vertebral body displacement, restore normal spinal position, reduce the oppression and stimulus of the vertebral artery, release ischemia of vestibular labyrinth, and eliminate the symptoms of vertigo.
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Effects of Chiropractic Care on Dizziness, Neck Pain,
and Balance: A Single-group, Preexperimental,
Feasibility Study
J Chiropractic Medicine 2009 (Dec); 8 (4): 156164 ~ FULL TEXT
This feasibility study was conducted to further the development of a line of investigation into the potential effects of spinal manipulation/manual therapy on cervicogenic dizziness, balance, and neck pain in adults.
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Chiropractic Care for Nonmusculoskeletal Conditions:
A Systematic Review With Implications For
Whole Systems Research
J Altern Complement Med. 2007 (Jun); 13 (5): 491512 ~ FULL TEXT
(1) Adverse effects should be routinely reported. For the few studies that did report, adverse effects of spinal manipulation for all ages and conditions were rare, transient, and not severe. (2) Evidence from controlled studies and usual practice supports chiropractic care (the entire clinical encounter) as providing benefit to patients with asthma, cervicogenic vertigo, and infantile colic. Evidence was promising for potential benefit of manual procedures for children with otitis media and elderly patients with pneumonia.
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Manual Therapy Treatment of Cervicogenic Dizziness:
A Systematic Review
Man Ther. 2005 (Feb); 10 (1): 413
Dizziness is a common and often disabling disorder. In some people the cause of their dizziness is pathology or dysfunction of upper cervical vertebral segments that can be treated with manual therapy. The aim of the present study was to systematically review the literature on the manual therapy treatment of patients with cervicogenic dizziness, by identifying and evaluating both randomized controlled trials (RCTs) and non-RCTs (controlled clinical trials and non-controlled studies).
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Vertigo, Tinnitus, and Hearing Loss in the Geriatric Patient
J Manipulative Physiol Ther. 2000 (Jun); 23 (5): 352362 ~ FULL TEXT
The patient received upper cervical-specific chiropractic care. Paraspinal bilateral skin temperature differential analysis was used to determine when an upper cervical adjustment was to be administered. Radiographic analysis was used to determine the specific characteristics of the misalignment in the upper cervical spine. Through the course of care, the patient's symptoms were alleviated, structural and functional improvements were evident through radiographic examination, and audiologic function improved.
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Cervical Vertigo After Hair Shampoo Treatment at a
Hairdressing Salon: A Case Report
Spine 2000 (Mar 1); 25 (5): 632634
The authors suggest that the hyperextended neck position during hair shampoo treatment in a beauty parlor may be a risk factor for back lifting or cerebellum vascular insufficiency. Public education should lead to avoidance of this position during hair shampoo treatment at hair dressing salons.
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A Combined Approach for the Treatment of Cervical Vertigo
J Manipulative Physiol Ther. 2000 (Feb); 23 (2): 96100
Chronic, nontraumatic, cervical and shoulder-girdle dysfunction was an important causal and perpetuating factor of cervical vertigo in the population studied, and a consistent improvement was observed with the use of a conservative treatment protocol involving multiple modalities for patients with cervical vertigo. Further controlled studies are needed to access its validity.
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Clinical Study on Manipulative Treatment of Derangement of
the Atlantoaxial Joint
J Tradit Chin Med 1999 (Dec); 19 (4): 273278
The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis. The clinical diagnosis of derangement consists of: dizziness, headache, prominence and tenderness on one side of the affected vertebra, deviation of the dens for 1 mm-4 mm on the open-mouth X-ray film, abnormal movement of the atlantoaxial joint on head-rotated open-mouth X-ray film. An accurate and delicate adjustment is the most effective treatment.
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Vertigo in Patients With Cervical Spine Dysfunction
European Spine Journal 1998; 7 (1): 5558
60% of the patients examined were assessed with upper cervical dysfunction, and 77.4% of them responded favorably to spinal manipulation.
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Therapy of Functional Disorders of the Craniovertebral
Joints in Vestibular Diseases
Laryngorhinootologie 1992 (May); 71 (5): 246250
Cervicogenic vertigo is caused by functional disorders of the craniovertebral joints. The therapeutic effect of chiropractic treatment in 28 patients with vertigo and purely functional disorders of the upper cervical spine or with a combination of functional disorders of the upper cervical spine and the labyrinth was evaluated. In our opinion chiropractic treatment is mandatory for the therapy of patients with vestibular affections and functional disorders of the craniovertebral joints.
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