Although the existence of cervicogenic dizziness or dizziness of cervical origin as an independent disease is still questioned, this symptom is a frequent complaint in the general population that causes numerous medical consultations.
The patient suffering from dizziness of cervical origin may report episodes of imbalance and/or dizziness accompanied by cervical pain, stiffness, tension, as well as muscle contracture that can extend to the posterior region of the neck and upper trunk (trapezius area). ).
The symptoms will appear temporarily, with an approximate duration of minutes or hours, as well as an increase in manifestations when performing cervical movements.
Neck pain may manifest from the beginning, reaching both sides of the head (temporoparietal region) or only appearing when deeply palpating the neck region.
What causes dizziness of cervical origin?
Some scientists deny the cervical origin of the symptoms described above.
They mainly hide behind the fact that there is no exact physiological mechanism that can justify them, while in most cases there are also other possible causes of dizziness.
Defenders of the cervical origin of dizziness have put forward several hypotheses, for example:
Barre-Lieou syndrome
He proposed that the abnormal entry at the cervical level of the sympathetic nerves, responsible for regulating the blood flow of the posterior circulation and the vessels of the inner ear, would generate a decrease in blood circulation (vasoconstriction) in the vertebrovasilar system and in the inner ear. (ischemia).
Patients may manifest:
• Dizziness
• Ringing in the ears (tinnitus)
• Headache
• Blurry vision.
• Dilated pupils
• Nausea
• Vomiting
Currently, it has been suggested that objective evidence is lacking to support this possible cause of cervical dizziness.
The vascular hypothesis
It poses the temporary compression or occlusion of one or both vertebral arteries when performing neck rotation movements, generally in patients with osteophytes located at the level of the first cervical vertebra (C 1), which can compromise cerebral blood supply and cause dizziness.
However, currently no hypothesis has been corroborated and the debate continues.
The diagnosis of cervical dizziness will be made mainly by exclusion
Since there is no specific test to diagnose this entity, the doctor must rule out the existence of other neurological, vestibular and psychosomatic diseases that may be associated with the symptoms presented by the patient.
A correct physical examination will be carried out, which includes neurological tests of vestibular exploration, for example, nystagmography and posturography.
Imaging tests at the cervical level, looking for structural or functional alterations, will help to make a proper diagnosis. Among them we can count on radiographs, computerized axial tomography, digital subtraction angiography, nuclear magnetic resonance, etc.
Once other causes of dizziness have been ruled out, this picture should be suspected in:
• Middle-aged women
• Older adults with cervical disorders
• Patients who have suffered traffic accidents, where there has been a rear blow while driving and the thorax is fixed by the use of a seat belt and the neck receives all the energy, causing injuries at this level (whiplash mechanism).
Treatment of cervical dizziness will depend on the cause.
EN 
ES