What is multisensory reponderation change before and after a therapeutic repositionning manoeuver of a vertical semicircular one-sided BPPV?

IRON, Paris, FranceE-mail address: cvnechel@ulb.ac.beKeywords: Vertigo; Dizziness; Imbalance; Cervical vertebrae; Cervicalgia‘‘Cervical vertigo’’ is rarely truevertigo but there are several experimental andclinical arguments in favour of a possible origin of cervical postural instability.Acorrectperceptionofthebodybalanceduringheadmovementrequiresbothavestibular signal and precise cervical static and dynamic proprioceptiveinformation. This finding alone is sufficient to validate the concept of a feelingof instability of cervical origin, called by some authors ‘‘cervical vertigo’’. Avascular mechanism is very rarely involved in the presence of two functionalvertebral arteries and a normal Willis polygon. The increase in the gain ofcervical-ocularreflexorthepresenceofacervicalnystagmusarenotconvincingarguments for a cervical origin of dizziness. Diagnostic criteria proposed in theliterature require a temporal relationship between neck pain and posturalinstability even during recurrences, and the lack of neck pain excludes thisdiagnosis. Finally, other causes of dizziness should be eliminated.Further readingBrooks JX, Cullen KE. Multimodal integration in rostral fastigial nucleusprovidesanestimateofbodymovement.JNeurosci.2009:26;29(34):10499-511.Wrisley DM, Sparto IJ, Whitney SI, Furman JM. Cervicogenic Dizziness: AReview of Diagnosis and Treatment. Journal of Orthopaedic & Sports PhysicalTherapy 2000: 30(12):755-766.http://dx.doi.org/10.1016/j.rehab.2013.07.327CO02-004-e