Abstract
‘Cervical vertigo’ comprises a symptomatic group of vertiginous diseases whose pathogenesis is believed to be in the neck region. The diagnosis of cervical vertigo is difficult, mainly because no examinations are particularly useful for the purpose. In this study, we examined whether any features —especially stabilometry with or without neck tilting, torsion, or extension— are occasionally observed in patients with cervical vertigo. The subjects were 10 patients with putative cervical vertigo, seven patients with unilateral peripheral vestibular disorders, and 17 healthy individuals. With regard to oculomotor symptoms, five of seven patients with peripheral vestibular disorders showed some pathological nystagmus. In contrast, only one out of seven patients with cervical vertigo showed pathological nystagmus. From an analysis of stabilometry, the control group exhibited some tottering only in the head-extended position. This tendency was also observed, though mildly, in patients with peripheral vestibular disorders. Most of the patients with cervical vertigo, however, readily displayed tottering in any neck position. Further, the difference in the tottering in cervical vertigo patients between those in the neck-tilted or extended position and those not in such a position was significantly greater than in the control group and in patients with peripheral vestibular disorders, however there was no clear difference in the results between subjects in the control group and those with peripheral vestibular disorders. These results indicate the following. First, an oculomotor phenotype is not necessarily exhibited in patients with cervical vertigo. Second, stabilometry with and without neck extension or tilting provides valuable information in the diagnosis of cervical vertigo.
