I. What is cervical vertigo?
Cervical vertigo, as the name implies, is vertigo related to the neck. It often occurs when the neck is moving, especially when the head is turned violently or tilted backwards excessively. In some cases, vertigo is accompanied by nausea, vomiting, and general sweating. In mild cases, it can get better in a few seconds, while in severe cases, it can last intermittently for several days or more before the symptoms gradually ease. The pathogenesis and pathophysiological process of cervical vertigo are complicated, and the most understood and well-studied now is caused by vertebral artery type cervical spondylosis.
Cervical spondylosis is a common and frequent disease that affects a wide range of people, from 21 to 83 years old, with a prevalence rate of 64.52% or more. Generally speaking, cervical spondylosis is a prevalent disease in middle-aged and elderly people, with a high prevalence between the ages of 40 and 60, and a prevalence of 90% after the age of 70. However, recent studies have shown that the prevalence of cervical spondylosis is trending younger. Although traditional cervical spine surgery has good clinical efficacy, there are some postoperative complications. With the advancement of basic research on cervical spondylosis, diagnostic imaging techniques and minimally invasive surgical techniques, there has been rapid development in minimally invasive treatment of cervical spondylosis in the past 10 years or so.
Vertigo.
Cervical vertigo is directly related to the location of the osteophytes, but not much related to the size of the growths. In some cases, although the hyperplasia is serious, the site of the hyperplasia is far away from the vertebral artery and cannot touch the wall of the vertebral artery, so the bone spur will not show symptoms even though it is large; in other cases, the bone spur does not directly compress or stimulate the vertebral artery, but it triggers edema in the tissues near the artery, which will also stimulate the vertebral artery and show symptoms. This is the reason why many patients with severe cervical spine enlargement do not have vertigo symptoms, while some people with insignificant enlargement can cause severe cerebral blood supply deficiency leading to vertigo.
Cervical vertigo arises in two ways. One is the mechanical compression of vertebral artery by bone spur and narrowing or occlusion; the other is the stimulation of cervical sympathetic nerve, which causes spasm of vertebral artery.
Second, what are the lesions that cause cervical vertigo?
1.Cervical spine bone damage
Such as degenerative changes of cervical spine, osteophytes, inflammation, trauma, etc.
2. Soft tissue lesions of the neck
Such as soft tissue damage in the neck, disc protrusion, radiculitis, etc.
What are the symptoms of cervical vertigo when it attacks?
1. Vertigo: it can be motion illusion vertigo, or dizziness, shaking, floating sensation, mostly occurring when the neck is in motion; sometimes it presents varicose vertigo when sitting up or lying down, and a few can have cochlear symptoms.
2. Neck and (or) occipital pain: mostly occurs in the morning when waking up
3. Cervical nerve root pressure compression symptoms: cell phone arm method, abnormal sensation and weakness.
4. May have foreign body sensation in throat and visual symptoms.
4.What are the characteristics of vertigo symptoms attack?
1.Vertigo: It is a motion illusion of body spatial orientation, which is wrong to rotate, shake and tilt to foreign objects and itself, and can coexist with nystagmus, balance disorder, nausea, vomiting, cold sweat, pale face and other vegetative symptoms. The emphasis is on a kind of motor hallucination, which is often referred to as the “spinning” sensation; the etiology is caused by vestibular nervous system pathology. Otolaryngological diseases should be considered.
This is the most common symptom in patients with cervical vertigo.
3. Dizziness: It is often characterized by persistent dizziness and lack of clarity, accompanied by heavy head, dull head, high head, forgetfulness, weakness and other symptoms of neurosis or chronic somatic diseases, and aggravated by exertion. It is caused by neurasthenia or chronic somatic diseases, etc.
4, syncope: sudden, transient loss of consciousness, accompanied by fainting. Consciousness is restored within a short time after fainting, and there is usually no eye tremor. It is caused by low blood pressure, slow heartbeat and transient cerebral ischemia due to various reasons.
V. Can young people suffer from cervical vertigo?
Generally speaking, cervical vertigo caused by degenerative lesions of the cervical spine is more common in middle-aged and elderly people. However, in recent years, there is a trend of younger patients in vertigo clinics. There are two main groups of people.
One group is those who are engaged in long-term occupations where the neck is often relatively fixed in one position, such as accountants, car drivers, copywriters and computer workers, and college students. These people are more static and less active, and the cervical spine is relatively fixed in one position for a long time, with little activity time, which is very likely to cause cervical degenerative lesions. In addition, the trend of increasing vertigo among high school students is also found in outpatient work.
The other group is people who have a history of trauma to the head and neck, sometimes dating back to decades of instant violent injuries.
VI. How to diagnose cervical vertigo?
1. Age Most of the cases are over 40 years old.
2. The onset of vertigo is often associated with changes in neck position.
3. The vertigo or nausea can be induced when the neck is posteriorly extended or rotated.
4.It may be accompanied by nerve root symptoms.
5.Sudden onset, often due to getting up or turning the head suddenly vertigo, often accompanied by horizontal nystagmus.
6, . Cervical spine examination Restricted cervical movement, distorted spinous processes of the affected vertebrae, and pressure pain next to the vertebrae. Cervical 2 spine distortion is common. Because the vertebral artery enters the transverse foramen and then rises vertically, multiple bends in the vertebral artery occur in this section from the 2nd cervical vertebra to before it enters the foramen magnum of the occipital bone, so obstruction of vertebral artery blood flow also occurs here.
7.Cerebral blood flow diagram Insufficient blood supply to the vertebrobasilar artery.
8.Cervical spine x-ray film The cervical spine physiological curve is straightened, reverted, angled or interrupted in the frontal and lateral films, left and right oblique and open position films. Osteomalacia. The posterior nodes of the cervical vertebrae are upturned, and the distance between the dentate process and the blocks on both sides is not equally wide.
9, laboratory tests: hemoglobin, blood glucose, lipids, urea nitrogen, etc. should be checked.
10.Other auxiliary examinations.
X-ray cervical spine can be seen in the cervical vertebral body, intervertebral disc, hook joint degeneration and calcification of the collateral ligament, cervical physiological curvature straightening and other changes.
Ultrasound shows that the blood flow of vertebral basilar artery is reduced.
VII. How to treat cervical vertigo?
1. The main treatment is cervical spine surgery, including cervical brace fixation, surgery if necessary, etc.
2. To improve the microcirculation in the inner ear by targeting the impaired blood supply in the inner ear.
Commonly used drugs include flunarizine, compound Chuanxiongzin, compound Danshen tablets, Duchenne, etc. To reduce blood viscosity: use dipyridamole, aspirin, etc.
3.Vestibular sedatives
Diazepam, promethazine, diphenhydramine, etc. are commonly used.
4.Physiotherapy and paravertebral injection of procaine are available. When taking non-steroidal antipyretic analgesics, caution should be exercised when performing this treatment for patients with initial attack.
5.Change the bad lying position: the pillow should not be too high or too low.
How to prevent cervical vertigo?
1.Long-term ambulatory workers and manual operators who keep their heads down for a long time will destroy the physiological curvature of cervical vertebrae and lead to cervical physiological curvature inversion (reverse bending), so it is advisable to take regular rest and carry out moderate head raising training at work. People engaged in computer operations, the neck for a long time fixed in a posture, but also easy to lead to strain injury of the neck muscles and ligaments, work should also be regular rest and appropriate activities to enhance the blood supply of the neck muscles and ligaments, enhance flexibility, to avoid cumulative strain injury.
2.Strengthen the neck muscles and ligaments
Active exercise of the neck muscles can effectively enhance the stability of the biomechanical structure of the cervical spine, strengthen the normal physiological curvature of the cervical spine, and promote blood and lymph circulation, which can effectively prevent and reduce cervical spondylosis. However, blind and wrong exercise may even bring serious consequences, especially for patients who already have cervical spine biomechanical structure instability, they should not perform intense exercises such as head shaking, neck forward extension, left and right swaying, head lowering, etc.
Breaststroke must keep the head up position, which is also conducive to maintaining the physiological curvature of the cervical spine, so often recommended by clinicians, however, cervical spine patients should also pay attention to avoid cold, so before entering the pool should do a full preparation exercise, enter the pool immediately after breaststroke, stop breaststroke should immediately go ashore to dress, to avoid staying in the pool for a long time and feel cold and wet.
3.Choose a suitable pillow
4, to prevent trauma and pillow, trauma (such as car accidents caused by the “whip injury”) may damage the neck muscles and ligaments, and further damage the stability of the cervical spine, and thus induce or aggravate cervical spondylosis. Pillow is also an injury, caused by improper use of pillows, so always after sleep onset.
5, avoid cold, cold will lead to muscle increase, loss of elasticity, and thus easy to damage, increased tension will also increase intervertebral disc pressure, compression gap and worsen the symptoms of nerve root compression, cold may also lead to increased inflammation around the nerve root.
6, caution with cervical traction, traction will lead to cervical spine physiological curvature straightening rather than recovery, so it is not often traction.