Can cervicogenic vertigo cause both a sensation of the room spinning and lightheadedness?

Cervicogenic Vertigo Symptoms

Cervicogenic vertigo typically presents as lightheadedness or a sense of disequilibrium rather than true rotational vertigo (room spinning sensation), which helps distinguish it from vestibular disorders like BPPV. 1

Distinguishing Cervicogenic Vertigo from Other Causes

Clinical Presentation of Cervicogenic Vertigo

• Symptoms are triggered by head rotation relative to the body while in an upright position (not by changes in head position relative to gravity) 1
• Associated with neck pain or cervical spine dysfunction 2
• Typically presents as:
  • Lightheadedness
  • Feeling "off balance"
  • Sense of disequilibrium
  • Rarely true rotational vertigo 1, 3

Contrast with BPPV (True Vertigo)

• BPPV causes true rotational/spinning vertigo triggered by specific head movements relative to gravity 4
• BPPV episodes typically last less than 60 seconds 4
• BPPV is diagnosed by characteristic nystagmus during the Dix-Hallpike maneuver 4
• BPPV symptoms are provoked by activities like:
  • Rolling over in bed
  • Tilting head upward
  • Bending forward 4

Pathophysiology of Cervicogenic Vertigo

Cervicogenic vertigo occurs due to:

• Proprioceptive abnormalities arising from cervical spine dysfunction 1
• Mismatch between vestibular, visual, and proprioceptive inputs 3
• Functional disorders of the craniovertebral joints 5

The cervical spine contains highly developed proprioceptive receptors that integrate with visual and vestibular systems. When cervical proprioceptive input is altered, it can lead to dizziness symptoms 3.

Diagnostic Considerations

• The cervical torsion test appears to be the most promising diagnostic method for cervicogenic vertigo 6, 3
• Diagnosis is often made by:
  • Presence of neck pain preceding or coinciding with dizziness
  • Exclusion of other causes of vertigo
  • Improvement with treatment of cervical dysfunction 2

Common Pitfalls in Diagnosis

• Mistaking cervicogenic vertigo for BPPV or other vestibular disorders
• Not recognizing that cervical spine disorders can cause dizziness symptoms
• Failing to distinguish between true rotational vertigo and lightheadedness/disequilibrium
• Not considering that neck pain and dizziness may coincide without being causally related 2

Treatment Approach

Manual therapy is most widely recommended for cervicogenic vertigo, similar to treatments for neck pain 3. A case report showed improvement with chiropractic treatments including spinal manipulation, soft tissue release, and rehabilitative exercises 7.

In summary, while cervicogenic vertigo remains somewhat controversial as a diagnosis, it typically presents as lightheadedness or disequilibrium rather than true room-spinning vertigo, which is more characteristic of vestibular disorders like BPPV.