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Musculoskeletal diseases as a causal factor of cervical vertigo

      Abstract

      Objective

      To analyze the frequency of musculoskeletal diseases in patients with cervical vertigo, as well as the relations of neck tenderness, psychiatric symptoms, and autonomic abnormalities with pain and age.

      Methods

      One hundred and seventy-six patients with cervical vertigo were analyzed. The groups with or without pain and the groups aged ≧66 years or ≦65 years old were compared.

      Results

      Musculoskeletal diseases were very common (present in 86%). In the group with pain, neck tenderness, CMI III–IV, and orthostatic hypotension were significantly more frequent. In the older group, neck tenderness and orthostatic hypotension were significantly more common than in the younger group. Abnormal ETT and OKP results were also frequently observed.

      Conclusions

      Musculoskeletal diseases might have a role in cervical vertigo. In addition, there seem to be some relations among neck tenderness, psychiatric symptoms, autonomic abnormalities, pain, and age. Furthermore, brain stem abnormalities may participate in cervical vertigo.

      Keywords

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      References

        • Hinoki M.
        Vertigo viewed from neurotology.
        1st ed. Kanahara & Co., Ltd., Tokyo2003
        • Hinoki M.
        Vertigo – theoretical and clinical considerations.
        1st ed. Kanehara & Co., Ltd., Tokyo1997 ([in Japanese])
        • Fukuda T.
        Studies on human dynamic postures from the viewpoint of postural reflexes.
        Acta Otolaryngol Suppl. 1961; 161: 9-52
        • Hinoki M.
        • Niki H.
        Neurotological studies on the role of the sympathetic nervous system in the formation of traumatic vertigo of cervical origin.
        Acta Otolaryngol Suppl. 1975; 330: 185-196
        • Hinoki M.
        Vertigo due to whiplash injury: a neurotological approach.
        Acta Otolaryngol Suppl. 1984; 419: 9-29
        • Gray L.P.
        Extra labyrinthine vertigo due to cervical muscle lesions.
        J Laryngol Otol. 1956; 70: 352-361
        • Michels T.
        • Lehmann N.
        • Moebus S.
        Cervical vertigo—cervical pain: an alternative and efficient treatment.
        J Altern Complement Med. 2007; 13: 513-518
        • Evans R.W.
        Some observations on whiplash injuries.
        Neurol Clin. 1992; 10: 975-997
        • Ferrari R.
        • Russell A.S.
        Neck pain.
        Best Pract Res Clin Rheumatol. 2003; 17: 57-70
        • Hinoki M.
        • Ushio N.
        Lumbomuscular proprioceptive reflexes in body equilibrium.
        Acta Otolaryngol Suppl. 1975; 330: 197-210
        • Hinoki M.
        • Hine S.
        • Ushio N.
        • Ishida Y.
        • Koike S.
        Studies on ataxia of lumbar origin in cases of vertigo due to whiplash injury.
        Int J Equilib Res. 1973; 3: 141-152
        • Ushio N.
        • Hinoki M.
        • Shizuku S.
        • Matsuura K.
        • Baron J.B.
        • Bessinetone J.C.
        • et al.
        Two phases of proprioceptive reflexes of ocular muscle origin from the standpoint of body equilibrium.
        Pract Otol (Kyoto) Suppl. 1976; 69 ([in Japanese]): 1356-1368
        • Ito S.
        • Hinoki M.
        • Miyoshi T.
        Correlation between the cervical proprioceptors and the otolith with regard to the development of nystagmus of cervical origin.
        Pract Otol (Kyoto) Suppl. 1983; 76 ([in Japanese]): 616-625
        • Ito S.
        • Hinoki M.
        Cutaneo-pressure reflex and neck-torsion nystagmus in rabbits.
        Pract Otol (Kyoto) Suppl. 1983; 76 ([in Japanese]): 603-615
        • Hinoki M.
        • Hine S.
        • Okada S.
        • Ishida Y.
        • Koike S.
        • Shizuku S.
        Optic organ and cervical proprioceptors in maintenance of body equilibrium.
        Acta Otolaryngol Suppl. 1975; 330: 169-184
        • Hinoki M.
        Experimental studies on eye movements of hippocampal origin in rabbits with a view to the neurotological approach to the analysis of neurotic vertigo in humans.
        Pract Otol (Kyoto) Suppl. 1983; 76 ([in Japanese]): 515-537
        • Hinoki M.
        Role of the visceral brain in body equilibrium.
        Acta Otolaryngol Suppl. 1985; 419: 30-52
        • Ichibangase T.
        Neurotological studies on so-called neurotic vertigo: a proposal of a new test, “Equilibrium tests for so-called neurotic vertigo”.
        Pract Otol (Kyoto) Suppl. 1976; 69 ([in Japanese]): 1415-1444
        • Hinoki M.
        Concept of a trigger-and target relationship in analysis of vertigo and ataxia after head and neck injury.
        Pract Otol (Kyoto) Suppl. 1976; 69 ([in Japanese]): 1641-1663
        • Nakagawa H.
        • Ohashi N.
        • Kanda K.
        • Watanabe Y.
        Autonomic nervous system disturbance as etiological background of vertigo and dizziness.
        Acta Otolaryngol Suppl. 1993; 504: 130-133
        • Ardic F.N.
        • Atesci F.C.
        Is psychogenic dizziness the exact diagnosis?.
        Eur Arch Otorhinolaryngol. 2006; 263: 578-581
        • Ketola S.
        • Havia M.
        • Appelberg B.
        • Kentala E.
        Depressive symptoms underestimated in vertiginous patients.
        Otolaryngol Head Neck Surg. 2007; 137: 312-315
        • Franz M.
        • Schepank H.
        • Schellberg D.
        Unspecific neurologic symptoms as possible psychogenic complaints.
        Eur Arch Psychiatry Clin Neurosci. 1993; 243: 1-6
        • Barozzi S.
        • Giuliano D.A.
        • Giordano G.P.
        • Cesarani A.
        Dynamic stabilometric findings in equilibrium disorders of the elderly.
        Acta Otorhinolaryngol Ital. 2005; 25: 220-223
        • Mouchnino L.
        • Gueguen N.
        • Blanchard C.
        • Boulay C.
        • Gimet G.
        • Viton J.M.
        • et al.
        Sensori-motor adaptation to knee osteoarthritis during stepping-down before and after total knee replacement.
        BMC Musculoskelet Disord. 2005; 26: 21
        • Lay C.M.
        Low cerebrospinal fluid pressure headache.
        Curr Treat Options Neurol. 2002; 4: 357-363
      1. Japan Society for Equilibrium Research. Clinical guide data in diagnosis and treatment for dizziness and equilibrium disorders. Equilib Res Suppl 1995; 11: 1–85 [in Japanese].

        • Brodman K.
        • Erdmann A.J.
        • Lorge I.
        • Deutschberger J.
        • Wolff H.G.
        The Cornell Medical Index-health questionnaire. VII. The prediction of psychosomatic and psychiatric disabilities in army training.
        Am J Psychiatry. 1945; 111: 37-40
        • Fukamachi K.
        The study on the Cornell Medical Index (II). A discriminative chart as screening test of neurotics by CMI.
        Fukuoka Acta Med. 1959; 50 ([in Japanese]): 3001-3009
        • Goddard G.V.
        • McIntyre D.C.
        • Leech C.K.
        A permanent change in brain function resulting from daily electrical stimulation.
        Exp Neurol. 1969; 25: 295-330
        • Ohno E.
        Seizure susceptibility increase and DC potential – in experimental epilepsy kindling.
        Fukushima Med J. 1979; 29 ([in Japanese]): 1-12
        • Morinaka S.
        The influence of daily electrical stimulation of the amygdala on optokinetic nystagmus in rabbits.
        Brain Res. 1990; 525: 205-208
        • Morinaka S.
        Correlation between the visceral brain and the brain stem maintenance in equilibrium – observations on changes in optokinetic nystagmus, EEGs and blood pressure in rabbits with repeated electric stimulation of the amygdaloid nucleus.
        Practica Otol (Kyoto) Suppl. 1986; 1 ([in Japanese]): 1-26
        • Mroczek D.K.
        • Almeida D.M.
        The effect of daily stress, personality, and age on daily negative affect.
        J Pers. 2004; 72: 355-378
        • Boddaert J.
        • Tamim H.
        • Verny M.
        • Belmin J.
        Arterial stiffness is associated with orthoatatic hypotension in elderly subjects with history of falls.
        J Am Geriatr Soc. 2004; 52: 568-572
        • Esparza C.M.
        • Jáurequi-Renaud K.
        • Morelos C.M.C.
        • Muhl G.E.A.
        • Mendez M.N.
        • Carillo N.S.
        • et al.
        Systemic high blood pressure and inner ear dysfunction: a preliminary study.
        Clin Otolaryngol. 2007; 32: 173-178
        • Yang C.S.
        • Young Y.H.
        Clinical investigation on hypotensive patients with vertigo.
        Eur Arch Otorhinolaryngol. 2006; 263: 804-808
        • Allcock L.M.
        • O'Shea D.
        Diagnostic yield and development of a neurocardiovascular investigation unit for older adults in a district hospital.
        J Gerontol A Biol Sci Med Sci. 2000; 55: M458-M462
        • Gupta V.
        • Lipsitz L.A.
        Orthostatic hypotension in the elderly: diagnosis and treatment.
        Am J Med. 2007; 120: 841-847
        • Kazmierczak H.
        • Pawlak-Osinska K.
        • Osinski P.
        Visuoocular reflexes in presbyvertigo.
        Int Tinnitus J. 2001; 7: 112-114
        • Gross A.R.
        • Goldsmith C.
        • Hoving J.L.
        • Haines T.
        • Peloso P.
        • Aker P.
        • et al.
        Conservative management of mechanical neck disorders: a systematic review.
        J Rheumatol. 2007; 34: 1083-1102
        • Heikkila H.
        • Johansson M.
        • Wenngren B.I.
        Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study.
        Man Ther. 2000; 5: 151-157
        • Ődkvist I.
        • Ődkvist L.M.
        Physiotherapy in vertigo.
        Acta Otolaryngol Suppl. 1988; 455: 74-76
        • Bracher E.S.
        • Almeida C.I.
        • Almeida R.R.
        • Duprat A.C.
        • Bracher C.B.B.
        A combined approach for the treatment of cervical vertigo.
        J Manipulative Physiol Ther. 2000; 23: 96-100