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本体感性颈源性头晕患者的颈部临床评估。

Clinical Evaluation of Neck in Patients with Proprioceptive Cervicogenic Dizziness.

机构信息

Department of Otolaryngology Head and Neck Surgery, University of São Paulo, São Paulo, SP, Brazil.

出版信息

Int Tinnitus J. 2022 Mar 3;25(2):143-148. doi: 10.5935/0946-5448.20210026.

Abstract

OBJECTIVE

To establish a functional connection between neck physical evaluations, dizziness discomfort and image findings among subjects diagnosed with proprioceptive cervical dizziness.

METHODS

After exclusion of peripheral vestibular disorders, 20 subjects with proprioceptive cervical dizziness hypothesis were selected. A Visual Analogue Scale (VAS) was used to quantify pain and vertigo. The active neck Range of Motion (ROM) and the Muscle Strength (MS) of the neck region were examined. The manipulation of vertebral bodies by the Maitland method and imaging scan were performed.

RESULTS

A positive correlation between pain and vertigo VAS scores was found. The ROM of the cervical spine was limited and vertebral joint movement was restricted, especially at C3 and C5. No loss of MS was noticed.

CONCLUSIONS

Proprioceptive cervical dizziness is usually an exclusion diagnosis among episodic chronic vertigos. Characteristically, it is reported by patients as instability or vertigo in crises. It is directly related to the neck ache severity and worsens with neck movements. The common pattern on clinical examination includes restriction and pain during neck flexion without loss of MS. Reduction of joint mobility and pain are also observed, especially at C3 and C54 kHz.

摘要

目的

在被诊断为本体感觉性颈性眩晕的患者中,建立颈部体格检查、头晕不适与影像学发现之间的功能联系。

方法

排除周围性前庭障碍后,选择 20 名本体感觉性颈性眩晕患者。使用视觉模拟量表(VAS)来量化疼痛和眩晕。检查颈部主动活动度(ROM)和颈部肌肉力量(MS)。采用 Maitland 手法对椎体进行操作,并进行影像学扫描。

结果

疼痛和眩晕 VAS 评分之间存在正相关关系。颈椎 ROM 受限,椎间关节活动受限,尤其是在 C3 和 C5。未发现 MS 丧失。

结论

本体感觉性颈性眩晕通常是阵发性慢性眩晕的排除性诊断。其特征是患者报告在危机中出现不稳定或眩晕。它与颈部疼痛的严重程度直接相关,并随着颈部运动而加重。临床检查中常见的模式包括颈部屈曲时的限制和疼痛,但不伴有 MS 丧失。关节活动度和疼痛减少也观察到,尤其是在 C3 和 C5 处。

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