Cervical vertigo. Diagnostic and semiological problem with special emphasis upon "cervical nystagmus".
There is a strong evidence that vertigo can be produced by cervical disturbance, either via the neck-proprioceptor, or via the vascular supply by the vertebral artery. However, it is very difficult to confirm the cervical origin of the vertigo in a particular patient. "Cervical nystagmus" has been proposed as a diagnostic clue. But critical analysis, discussed in this paper, has raised doubt about its reliability. The most know type, the neck torsion nystagmus, appears to be in fact a "normal" cervico-ocular reflex. Its inconstancy and low gain makes that it is only present in 50% of the subjects. Reduced vestibular input as well as enhanced cervical proprioceptive input favour its appearance. In this way the presence of NTN is suggestive for a cervical component but doesn't mean that the vertigo is cervical. Correlation with other cervical data is needed to conclude to a "cervical component" in the vertigo.
Norré
M E
ME
Department of Otoneurology and Equilibriometry, University of Leuven.
D006801:Humans; D009333:Neck / Q000503:physiopathology*; D009759:Nystagmus, Pathologic / Q000503:physiopathology*; D011434:Proprioception; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014103:Torticollis / Q000503:physiopathology; D014652:Vascular Diseases / Q000503:physiopathology; D014715:Vertebrobasilar Insufficiency / Q000503:physiopathology; D014717:Vertigo / Q000503:physiopathology*