Is a Definitive Diagnosis of Cervical Vertigo Possible in 2020? A Narrative Review and a Proposed Diagnostic Algorithm

Vestibular symptoms are a non-specific, world wide phenomenon with potential for lasting health and economic impact. Vestibulopathy can vary in etiology from peripheral to central and can be influenced by vascular, neurologic and musculoskeletal comorbidities. The cervical spine has defined neuroanatomical links to the vestibular system. However, vestibular symptoms attributed to cervical spine sources has been a contentious diagnostic theory. Cervical vertigo and cervicogenic dizziness are some of the proposed diagnoses. This paper reviews the history of the diagnoses and the established anatomical interconnections between the cervical spine and vestibular system. The current literature is also reviewed for evidence regarding: etiology; patient characteristics, and; for the existence of sufficiently powerful tests to diagnose cervicogenic vestibular symptoms. Based on the recent literature, a new diagnostic algorithm is proposed and an attempt is made to assess the ability to definitively diagnose Cervical Vertigo.