Cervicogenic Dizziness Associated With Craniocervical Instability: A Case Report.

Area of Science:

• Neurology
• Orthopedics
• Audiology

Background:

• Cervicogenic dizziness (CGD) presents as illusory motion and disequilibrium from cervical spine pathologies.
• A 40-year-old male experienced persistent neck pain, dizziness, and aural symptoms despite a prior Meniere's disease diagnosis and treatment.

Observation:

• The patient's symptoms persisted after standard Meniere's disease treatment.
• Radiographic analysis revealed subtle occiput anterolisthesis, indicated by a dissociated clivo-axial angle (CXA).
• Neurological, vascular, and vestibular causes were excluded, leading to suspicion of craniocervical instability.

Findings:

• Craniocervical instability was identified as the likely cause of CGD in this patient.
• A multi-component intervention including spinal manipulation, traction, and ultrasound therapy was administered.
• The patient experienced significant symptom relief after a 3-month treatment course without neurological complications.

Implications:

• This case highlights the importance of subtle radiographic clues, like CXA, in diagnosing CGD.
• The clivo-axial angle (CXA) can serve as a valuable assessment tool for craniocervical instability.
• Effective management of CGD may involve addressing underlying craniocervical instability through targeted interventions.