We have investigated and discussed the possible mechanisms of dizziness or vertigo due to involvement of the cervical sympathetic system with data obtained by stimulating the stellate ganglion and the vertebral nerve or plexus in a series of 15 patients during surgical treatment of episodic vertigo (Powers' syndrome)
12.
Some of the neural pathways and the mechanisms of cervical vertigo due to disorders of the cervical sympathetic system are postulated.
The data obtained is summarized as follows:
1) Stimulation of the periarterial nerve produced manifold varieties of pupillary changes with or without ocular movements, nystagmus and subjective symptoms; the pupillary changes included slow and mild mydriasis or miosis either on the ipsilateral or contralateral pupil and the hippus.
Ocular movements, nystagmus and subjective symptoms observed in only some of the cases included conjugate or disconjugate eye movements, horizontal and vertical nystagmus, and occipito-cervical dull ache and dizziness.
2) Stimulation of the stellate ganglion produced prompt and full mydriasis of ipsilateral pupil without any subjective symptom, coular movement or nystagmus. From the data available, it seems likely that:
3) Periarterial nerve structure including the vertebral nerve and plexus (which had been called the "deep or posterior cervical sympathetic system" by French investigators) is functionally or physiologically different from the cervical sympathetic system, including the inferior sympathetic or the stellate ganglion (which had been called the "anterior cervical sympathetic system" by French investigators).
4) The stellate ganglion proper has little significance in a development of the cervical vertigo.
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