Karlberg M, Johansson R, Magnusson M, Fransson P A
Department of Oto-rhino-laryngology, University Hospital, Lund, Sweden.
J Vestib Res. 1996 Jan-Feb;6(1):37-47.
Useful clinical tests are lacking for the controversial entity "cervical vertigo". In earlier studies patients assumed to suffer from cervical vertigo or dizziness manifested disturbed postural control as compared to healthy subjects, but were hard to distinguish from patients with other balance disorders. Using posturography in which stance was perturbed by a vibratory stimulus applied towards the calf muscles, we studied 16 consecutive patients with recent onset of neck pain and concomitant complaints of vertigo or dizziness, but normal findings at otoneurological examination and electronystagmography; 18 patients with recent vestibular neuritis; and 17 healthy subjects. We performed system identification of a model of the control of upright human stance, using the vibratory stimulus as input and the recorded body sway as output. According to values for the three normalized parameters of the transfer function of the model (i.e., swiftness, stiffness, and damping), cervical vertigo patients were distinguished both from healthy subjects (P < 0.001), and from vestibular neuritis patients (P < 0.001). It was also possible to distinguish the vestibular neuritis group from the group of healthy subjects (P < 0.01). The results show disturbed postural control in patients with cervical vertigo to differ from that in patients with recent vestibular neuritis, and indicate posturographic assessment of human posture dynamics to be a possible future tool for use in diagnosing cervical vertigo.
对于存在争议的“颈性眩晕”这一病症，目前缺乏有效的临床检测方法。在早期研究中，被认为患有颈性眩晕或头晕的患者与健康受试者相比，表现出姿势控制障碍，但很难与其他平衡障碍患者区分开来。我们采用姿势描记法，通过向小腿肌肉施加振动刺激来干扰站姿，对16例近期出现颈部疼痛并伴有眩晕或头晕主诉、但耳神经学检查和眼震电图检查结果正常的连续患者；18例近期患有前庭神经炎的患者；以及17名健康受试者进行了研究。我们以振动刺激作为输入，记录的身体摆动作为输出，对人体直立姿势控制模型进行了系统识别。根据模型传递函数的三个归一化参数值（即敏捷度、刚度和阻尼），颈性眩晕患者与健康受试者（P < 0.001）以及前庭神经炎患者（P < 0.001）均有明显区别。同时，也能够将前庭神经炎组与健康受试者组区分开来（P < 0.01）。结果表明，颈性眩晕患者的姿势控制障碍与近期前庭神经炎患者不同，提示人体姿势动力学的姿势描记法评估可能成为未来诊断颈性眩晕的一种工具。
