Vestibulospinale Reaktionen bei der zervikogenen Gleichgewichtsstörung

Abstract

A functional cervical spine disorder is often the cause for persistent vertigo, which can last months or several years. The existence of cervical vertigo is not generally recognized, mainly because an objectivation of the cervical nystagmus is not easily understood by many examiners. In this study we examine additional parameters, which underline the diagnosis of cervical imbalance. The anamnestic statement of staggering refers to a disturbance of the vestibulospinal reactions. In 67 patients in which cervical imbalance was suspected the vestibulospinal reactions were monitored directly before and after manual therapy of the cervical spine. The cranio-corpo-graphie (CCG) and the posturography were used to monitor the results. A highly significant improvement of pathological vestibulospinal reactions was seen after chiropractic manipulation of the spine. These results show that a functional disorder of the cervical vertebrae influences the vestibulospinal reactions. The pathological deficit of the vestibulospinal reactions is not solely a phenomenon of peripheric labyrinth malfunction, failure in the brainstem or in the area of the cerebellum ("brain stem staggering"), but can also be viewed nearly regularly by cervical disturbance of the equilibrium. The results of the treatment can be observed within a few hours.

Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review

“…Although these were generally of poor methodological quality they also reported improvements in additional outcome measures, including: neck pain [86], reduction of pathological vestibulospinal activity [84], balance [86], and reduced vertebral displacement and vertebrobasilar artery blood flow velocity [85] The remaining cohort study [75] reported improvements in skull spatial offset repositioning ability post treatment. Collectively, these findings provide further rationale for the use of manual therapy in the treatment of cervicogenic dizziness.…”

Effektivit�t der manuellen Medizin in der HNO

“…In früheren Arbeiten wurde berichtet, dass sich sofort oder bis zu 2-3 Tage nach einer manuellen Therapie auffällige Befunde im CCG normalisieren [8],ein propriozeptiver Zervikalnystagmus nicht mehr nachweisbar ist [6,7], eine Hörschwellen-abwanderung im Audiogramm sich zurückbildet [5] und dass auch bei der zervikalen Dysphonie pathologische Befunde in der Videostroboskopie und im Sonogramm nicht mehr erkennbar sind [4].…”

“…Schwindel: Wie in mehreren Publikationen dargelegt, wird eine vertebragene Gleichgewichtsstörung und Schwindelsymptomatik diagnostiziert, wenn bei unauffälligem peripherem Gleichgewichtsbefund ein propriozeptiver Zervikalnystagmus und ein pathologischer Befund bei der Posturographie und der Kraniokorpographie erhoben werden kann [6,7,8]. Es steht also ein pathologisch-positiver Befund zur Verfügung, der die Diagnose einer zervikalen Gleichgewichtsstörung zulässt.…”

Objective evaluation of neck muscle tension and static balance in patients with chronic dizziness

“…Posturographic analyses have clearly shown effects on the balance system in patients with vertigo and dysfunctions of the cervical spine [5]. Abnormal static and dynamic balance parameters have been observed in chronic neck pain patients with vertigo, and these findings can be explained by impaired cervical proprioception [6].…”