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Copyright2015 Korean Society of Otorhinolaryngology-Head and Neck Surgery177

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(cervical vertigo),

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The Diagnosis and Treatment of the Cervical VertigoJoo Young Kim, Wee Hwang Kim, Jang Soo Lee, Hyun Myung Oh,

Dae Woong Kim, and Dong Jin Choi

Department of Otolaryngology-Head and Neck Surgery, Kwangju Christian Hospital, Gwangju, Korea

Received

June 13, 2014

Revised September 3, 2014

Accepted September 8, 2014

Address for correspondence

Dong Jin Choi, MD

Department of Otolaryngology-

Head and Neck Surgery,

Kwangju Christian Hospital,

37 Yangnim-ro, Nam-gu,

Gwangju 503-715, Korea

Tel +82-62-650-5095

Fax +82-62-650-5090

E-mail brok-kim@hanmail.net

Background and ObjectivesZZVertigo is an illusion of environmental movement due to var-

ious causes, thus it is hard for medical doctors to determine the exact kind of dizziness in the

nal diagnosis. Recently, cervical vertigo was reported from several vertigo cases. Cervical ver-

tigo is dened as sensation of rotation, resulting from an alteration of the neck proprioceptive

afferents of the upper cervical spine. The aim of our study is to document the clinical features

and the treatment outcomes in vertigo patients with myofascial pain syndrome(MPS).

Subjects and MethodZZA total of 488 patients, excluding 18 patients who received other di-

agnosis, were examined to investigate the reasons for dizziness. We evaluated 34 patients, who

were diagnosed with cervical vertigo by questionnaire after MPS treatments. Clinical evalua-

tions for cervical vertigo were performed on all subjects, and vestibular function tests were also

performed in patients with vertigo symptoms. All patients received a total of 4 t reatments in-

cluding trigger point injection, physical therapy or medication, and then followed up, respec-

tively. The symptom changes of dizziness, patient satisfaction and cervical pain were checked

before and treatment 1, 2, 4 times by Visual Analogue Scale(VAS)score.

ResultsZZThere were signicant improvement in the VAS score of dizziness, patient satisfac-

tion and cervical pain after treatment for MPS.

ConclusionZZTreatment for MPS could improve dizziness in cervical vertigo with MPS pa-

tients, but further study is needed to clearly conrm the cervical vertigo with MPS for improv-

ing patients quality of life. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(3):177-81

Key WordsZZMyofacial pain syndromeTrigger pointVertigo.

Otology Korean J Otorhinolaryngol-Head Neck Surg2015;58(3):177-81 / pISSN 2092-5859 / eISSN 2092-6529http://dx.doi.org/10.3342/kjorl-hns.2015.58.3.177

onlineMLComm

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Korean J Otorhinolaryngol-Head Neck Surg2015;58(3):177-81

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(myofascial pain syndrome, MPS)

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ger pont injection, TPI)

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(temporalis muscle), (sternocleido-

mastoid muscle),(cervical paraspinatus

muscle),(levator scapular muscle), (upper

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Fig. 1.Dermographic distribution of ve muscles arounding thehead, neck, and shoulders that were checked for myofascial triggerpoints.

Temporalis muscle

Sternocleidomastoid muscle

Cervical paraspinal muscle

Levator scapulae muscle

Upper trapezius muscle

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Cervical Vertigo Kim JY, et al.

www.jkorl.org179

. VAS

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0

.VAS

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SPSS 17.0

(SPSS Inc., Chicago, IL, USA)Fishers exact

test, , ,

unpaired t-test.

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Wilcoxon signed rank test.

95% (p-value0.05).

268

(54.9%), 98(20.1%), 58(11.9%),

34(7.0%), 5(1.0%),

3(0.6%), 22(4.5%)

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121, 47, 43,

15, 3, 1,

13.

147, 51, 19,

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(p0.05, by Fishers exacttest). , 4,

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34(19,15

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23.55.6(: 22.34.2, : 24.16.1),

15.54.7(: 14.95.4,: 15.93.1).

2.71.1(: 2.61.4, : 2.91.9).

(p0.05, by unpaired t-test)(Table 2).

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Table 2.Characteristics of cervical vertigo group

Variables Cervical vertigo group

Sex(M:F) 19:15

Age(M:F) 42.7(42.5:43.4)*

Symptom duration(days)

(M:F)

23.55.6(22.34.2:24.16.1)*

Duration of treatment(days)

(M:F)

15.54.7(14.95.4:15.93.1)*

Number of trigger points(M:F) 02.71.1(2.61.4:2.91.9)*

*p0.05, by unpaired t-test. M:male, F:female

Table 1.The distribution of nal diagnosis in dizziness 488 cases

Disease Cases(male:female) %

BPPV 268(147:121)* 54.9

VN 098(51:47)* 20.1

Menieres disease 058(15:43)* 11.9

Cervical vertigo 034(19:15)* 07.0

CVA 005(2:3)* 01.0

Infectious disease 003(2:1)* 00.6

Others 022(9:13)* 04.5

*p0.05, by Fishers exact test. BPPV:benign paroxysmal posi-tional vertigo, VN:vestibular neuritis, CVA:cerebrovascularaccident

Table 3.The comparison between pretreatment VAS score and posttreatment VAS score checked at 1, 2, and 4 times after treatmentfor vertigo, patients satisfaction and cervical pain (meanSD)

VariablesVAS score

Vertigo Patients satisfaction Cervical pain

Pretreatment 8.461.30* 1.480.94* 7.841.51*

Posttreatment(1st) 3.530.95* 7.511.51* 4.511.65*

Posttreatment(2nd) 2.960.84* 8.140.48* 3.150.95*

Posttreatment(4th) 1.941.15* 8.950.45* 2.861.12*

*p0.05, by Wilcoxon signed rank test. VAS:Visual Analogue Scale, SD:standard deviation

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Korean J Otorhinolaryngol-Head Neck Surg2015;58(3):177-81

180

(p0.05, by Wilcoxon signed rank test)(Table 3).

41.1%.

33.4%. , ,

13.6%, 8.5%, 3.4%(Table 4).

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Table 4.Distribution of trigger points in neck and shoulder musclesfor patients with cervical vertigo with MPS

Muscle Cervical vertigo group (%)

Temporalis 03.4

Sternocleidomastoid 08.5

Cervical paraspinatus 33.4

Upper trapezius 41.1

Levater scapular 13.6

MPS:myofascial pain syndrome

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Cervical Vertigo Kim JY, et al.

www.jkorl.org181

.

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