The diagnosis of Cervicogenic Dizziness is one of exclusion. What this means is that the clinician should make sound reasoning to rule out other conditions that could be causing dizziness. We created our own algorithm, which we call the “Optimal Sequence Algorithm” to help clinicians come up with appropriate clinical decision making.
The main reason of this “exclusion rule”, is that dizziness is a red flag! It could be a benign condition or a symptom of a very serious underlying disorder.
With that said, the two most common conditions that are mistaken for Cervicogenic Dizziness is Benign paroxysmal positional vertigo (BPPV) and a vascular insult, such as vertebral basilar insufficiency (VBI) or collectively known as Cervical Artery Dysfunction (CADF).
The main reason we need to be aware of these two conditions is simple:
- BPPV is benign — a non-life threatening condition. It can be treated by a rehabilitation professional, such as a physical therapist.
- VBI and CADF — a life-threatening condition. It should not be treated by a rehabilitation professional, such as a physical therapist, initially. It should be direct route to other medical examinations and hopefully just pharmacological intervention before anything worse happens.
Cervicogenic Dizziness is also a non-life threatening condition. Therefore, a clinician who sees someone with dizziness, headache, lightheadiness, drunkenness, unsteadiness, loss of balance, etc. should absolutely have a foundation of ruling out spontaneous arterial events and then mechanical arterial events prior to examining the cervical spine’s joint and muscle mobility & performance.
You can learn more about the screening and treatment process of Cervicogenic Dizzinesss through Integrative Clinical Concepts, where the author and his wife, a Vestibular Specialist, teach a 2-day course. Pertinent to this blog post, the first day provides the most up-to-date evidence review from multiple disciplines to diagnose through the “Optimal Sequence Algorithm” to assist in ruling out disorders and ruling in cervical spine, including determining if single or double entity exists.
If you would like to host a course for your staff (either a vestibular, neuro, sports or ortho clinic), please do not hesitate to contact me at harrisonvaughanpt@gmail.com for prices and discounts.
Authors
Harrison N. Vaughan, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT
Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts
Danielle N. Vaughan, PT, DPT, Vestibular Specialist
Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts
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