Sympathetic nerve dysfunction occurs due to factors such as disc degeneration and segmental instability, thereby causing stimulation of sympathetic nerve endings around the cervical spine. Sympathetic cervical spondylosis has a wide range of symptoms, most of which are sympathetic excitation symptoms and a few are sympathetic inhibition symptoms. Since the surface of the vertebral artery is rich in sympathetic nerve fibers, when sympathetic nerve dysfunction occurs, the vertebral artery is often involved, resulting in abnormal diastolic function of the vertebral artery. Therefore, sympathetic cervical spondylosis is often accompanied by inadequate blood supply to the vertebrobasilar artery system in addition to the symptoms of several systems in the body.
I. Clinical manifestations.
Sympathetic cervical spondylosis is characterized by patients with many complaints but few objective signs and a wide variety of symptoms.
1. Head symptoms
Such as dizziness or vertigo, headache or migraine, head sinking, occipital pain, poor sleep, memory loss and difficulty in concentration. Patients often complain of mental confusion and drowsiness, and some even have memory loss; some patients also have nausea and rarely vomit. Occasionally, patients may fall down due to dizziness.
2.Eye, ear, nose and throat symptoms
Eye swelling, dryness or tearfulness, vision changes, blurred vision; tinnitus, ear blockage, hearing loss; nasal congestion, “allergic rhinitis”, foreign body sensation in the throat, dry mouth, vocal cord fatigue, etc.; taste changes, etc.
3.Gastrointestinal symptoms
Nausea or even vomiting, bloating, diarrhea, indigestion, belching, and foreign body sensation in the throat, etc.
4.Cardiovascular system symptoms
Palpitations, chest tightness, changes in heart rate, arrhythmia, changes in blood pressure, etc.
5. Symptoms of the face or a certain limb
Excessive sweating, no sweating, chill or fever, sometimes feeling pain and numbness, but not according to the distribution of nerve segments or travels. The above symptoms are often clearly related to the neck activity, aggravated when sitting or standing, and alleviated or disappeared when lying down. It is obvious when there are many neck activities, prolonged head bowing, working too long in front of the computer or exertion, and improves after rest.
6.Other
Cold limbs and fear of cold, there may also be less sweating on one side of the limb, and numbness of the head, neck, face or limbs.
II. Diagnosis.
Diagnosis is difficult, and there is a lack of objective diagnostic indicators. Clinical manifestations of sympathetic nerve dysfunction and imaging show segmental instability of the cervical spine are present. In some patients with atypical symptoms, if the symptoms are reduced after planetary ganglion closure or high cervical epidural closure, it will help the diagnosis.
III. Differential diagnosis
1.Otogenic vertigo
Vertigo is caused by vestibular dysfunction in the inner ear. Such as Meniere’s syndrome and embolism of the auditory artery in the ear.
2.Ocular vertigo
Refractive error, glaucoma and other ophthalmic disorders.
3.Brain-derived vertigo
Insufficient blood supply in vertebrobasilar artery due to atherosclerosis, lacunar cerebral infarction; brain tumor; sequelae of traumatic brain injury, etc.
4.Vascular vertigo
Insufficient blood supply to vertebrobasilar artery due to stenosis of V1 and V3 segments of vertebral artery; hypertension, coronary heart disease, pheochromocytoma, etc.
5.Other causes
Diabetes, overexertion, long-term sleep deprivation, etc.
IV. Treatment
Early cervical spondylosis, mainly manifested as soreness and tightness in the neck and back of the shoulder, headache, dizziness, numbness of the upper limbs, the degree of which is relatively mild, can first not do special treatment, pay attention to the following aspects of regulation.
1.Pay attention to proper rest
Avoid lack of sleep. Lack of sleep, excessive tension at work and long hours of continuous fixed posture will lead to excessive tension of the neuromuscles and strengthen the symptoms of cervical spondylosis.
2.Actively exercise
The correct exercise can strengthen the muscle strength, strengthen the normal physiological curvature of the cervical spine, increase the stability of the biomechanical structure of the cervical spine, and promote the circulation of blood and lymph, which is beneficial to the recovery of cervical spondylosis.
3, can use hot compress
For the relief of local neuromuscular tension has a certain role.