Zur klinischen Bedeutung zerviko-okulärer Reaktionen

Holtmann, Stefan; Reiman, V.; Schöps, P.

doi:10.1055/s-2007-997906

Cited by 24 publications

(5 citation statements)

References 7 publications

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“…We agree with Fischer et al in distinguishing either spontaneous or positional nystagmus arising in certain static head positions from the previously reported ''cervical nystagmus'', because static labyrinthine stimulation may exist [25]. Several Authors failed to demonstrate a relationship between nystagmus and neck proprioceptors' stimulation [18,19,26]. Also in our series any spontaneous and/or ''cervical nystagmus'' was noted neither in neutral position nor after 308 left/right rotation.…”

Section: Discussionsupporting

confidence: 89%

Analysis of visually guided eye movements in subjects after whiplash injury

et al. 2011

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Objective: The aims of present research were to analyze the visually guided eye movements of subjects suffering from the consequences of whiplash injury and the possibility to differentiate patients from feigning subject. We analyzed the role of video-nystagmography for clinical and forensic aspects. Methods: It was a prospective case-control study. Detailed history was taken and patients were thoroughly investigated. Smooth pursuit and saccadic eye movements were assessed in 33 patients affected by imbalance following a whiplash injury. A control group of 20 subjects was also evaluated. All tests were executed in neutral neck position and after left and right trunk rotation. Results: The t-test, applied to all parameters showed that difference of the parameter between the groups was not statistically significant. Conclusion: The visually guided eye movement evaluation does not seem to offer a clinically relevant method to differentiate patients suffering from the effects of whiplash injury from normal subjects. #

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Section: Discussionsupporting

confidence: 89%

Analysis of visually guided eye movements in subjects after whiplash injury

et al. 2011

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“…We concur with Fischer et al [47] in distinguishing either spontaneous or positional nystagmus arising in certain static head positions from the previously reported "cervical nystagmus" because static labyrinthine stimulation may exist. Several authors have failed to demonstrate a relationship between nystagmus and neck proprioceptors' stimulation [30,31,48].…”

Section: Discussionmentioning

confidence: 99%

Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?

Dispenza

Stefano

Mathur

et al. 2011

American Journal of Otolaryngology

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Objective: The aim of the study was to evaluate the true incidence, diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV) arising after whiplash injury and to distinguish this type of posttraumatic vertigo from other types of dizziness complained after trauma.Methods: This was a retrospective study comprising patients referred to our center after whiplash injury. The patients were evaluated with neurotologic examination including bedside and instrumental tests. A Dizziness Handicap Inventory evaluating the symptoms of patients was submitted before and after treatment and was evaluated. The BPPV patients were separately evaluated from those with cervicogenic vertigo, and a comparison between our data about idiopathic BPPV was done.Results: Eighteen patients of whiplash who had BPPV were evaluated. The mean age was 38.2 years. BPPV was the cause of vertigo in 33.9% of total whiplash patients. In 16 cases, the posterior semicircular canal was involved; the lateral semicircular canal was involved in 2 cases. The instrumental neurotologic assessment did not show any alteration of either vestibulospinal reflexes or dynamic ocular movements. Duration of symptoms before treatment ranged from 3 to 26 days. A total of 55.5% of patients had relief from their symptoms after first repositioning maneuver. The Dizziness Handicap Inventory score improved in all patients treated with repositioning maneuvers, but no difference emerged with idiopathic BPPV data. Conclusion: BPPV after whiplash injury could be unveiled with a simple bedside examination of peripheral vestibular system, and a treatment could be done in the same session. The diagnosis of posttraumatic BPPV is not different from the idiopathic form, but the treatment may require more maneuvers to achieve satisfactory results.

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“…Cervical inputs can generate a weak cervico-ocular reflex (COR) nystagmus in humans during trunk rotations in the dark, with the head fixed in space. One study noted equivalent COR responses in 40 healthy subjects versus 30 patients with problems of the upper cervical spine [ 46 ]. The COR, which is more prominent in patients with peripheral vestibular dysfunction [ 47 ], can be enhanced in such patients with neck muscle vibration [ 48 ] or following vestibular rehabilitation exercises [ 49 ], indicating the COR’s plasticity.…”

Section: Pathophysiologymentioning

confidence: 99%

The Bárány Society position on ‘Cervical Dizziness’

Seemungal

Agrawal

Bisdorff

et al. 2022

VES

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This paper describes the Bárány Society Classification OverSight Committee (COSC) position on Cervical Dizziness sometimes referred to as Cervical Vertigo. This involved an initial review by a group of experts across a broad range of fields, and then subsequent review by the Bárány Society COSC. Based upon the so far published literature, the Bárány Society COSC takes the view that the evidence supporting a mechanistic link between an illusory sensation of self-motion (spinning or otherwise) and neck pathology and/or symptoms of neck pain - either by affecting the cervical vertebra, soft tissue structures or cervical nerve roots - is lacking. When a combined head and neck movement triggers an illusory sensation of spinning, there is either an underlying common vestibular condition such as migraine or BPPV or less commonly a central vestibular condition including, when acute in onset, dangerous conditions such as a dissection of the vertebral artery with posterior circulation stroke and, exceedingly rarely, a vertebral artery compression syndrome. The Committee notes however, that migraine, including vestibular migraine, is by far, the commonest cause for the combination of neck pain and vestibular symptoms. The committee notes that since head movement aggravates symptoms in almost any vestibular condition, the common finding of increased neck muscle tension in vestibular patients, may be linked as both cause and effect, to reduced head movements. Additionally, there are theoretical mechanisms, which have never been explored, whereby cervical pain may promote vaso-vagal, cardio-inhibitory reflexes and hence by presyncopal mechanisms, elicit transient disorientation and/or imbalance. The committee accepts that further research is required to answer the question as to whether those rare cases in which neck muscle spasm is associated with a vague sense of spatial disorientation and/or imbalance, is indeed linked to impaired neck proprioception. Future studies should ideally be placebo controlled and double-blinded where possible, with strict inclusion and exclusion criteria that aim for high specificity at the cost of sensitivity. To facilitate further studies in “cervical dizziness/vertigo”, we provide a narrative view of the important confounds investigators should consider when designing controlled mechanistic and therapeutic studies. Hence, currently, the Bárány COSC, refrains from proposing any preliminary diagnostic criteria for clinical use outside a research study. This position may change as new research evidence is provided.

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Zur klinischen Bedeutung zerviko-okulärer Reaktionen

Cited by 24 publications

References 7 publications

Analysis of visually guided eye movements in subjects after whiplash injury

Analysis of visually guided eye movements in subjects after whiplash injury

Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?

The Bárány Society position on ‘Cervical Dizziness’

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