Spinning sensation of head or vertigo occurs when there is a pathology affecting the vestibular apparatus or its connections like- fibers from cerebellum or ascending tracts from vestibular apparatus to brain through brain stem.
Some believe that due to Cervical spondylosis the vertebral artery may get compressed resulting in vertigo. But the vertebral artery is a bilateral vessel which passes through a bony foramen / canals in the vertebral bone. Only very severe cervical spondylosis will result in bilateral vertebral artery compromise.
Even if the vertebral artery is compromised, it impairs the blood flow to the brain stem fully and not just to the vestibular apparatus. In such a situation where the vertebral artery or its branches like PICA is affected, the patient will have other symptoms/ signs along with vertigo- like gait ataxia / Horner’s syndrome/ sensory disturbance in face.
Then why is the misconception that Cervical spondylosis cause vertigo prevalent among our practitioners?
Both Cervical spondylosis and Benign Paroxysmal Positional vertigo are diseases seen in advancing age. There fore a patient with Cervical spondylosis may also have an underlying BPPV.
Neck collar given for Cervical spondylosis often provide improvement for the BPPV symptoms too by preventing sudden change in head position.
This observation resulted in the misconception that Cervical spondylosis causes vertigo.
So what should you do if you have both Cervical spondylosis and vertigo??
Meet your vertigo specialist or neurologist and get reevaluated to understand the actual cause before you self treat!
About the Author
Dr. N. Balamurugan, MD., DM., Senior Consultant neurologist with 28 years of clinical experience. He is a renowned clinician, academician and teacher. He is a Gold Medalist in DM neurology from the prestigious institute NIMHANS Bangalore. He is a full time consultant and Founder Director of the SIMS Hospital Salem, Tamil Nadu. He is an academician and a motivating teacher for thousands of young doctors like me.
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