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Determinanten des zervikalen Schwindels
Determinanten des zervikalen Schwindels
Background: Cervical dizziness or vertigo is defined as dizziness in connection to simultaneous neck pain. After excluding every differential diagnosis for dizziness, in the current state of knowledge, cervical vertigo is traced back to a dysfunction of muscles, joints and ligaments in the cervical spine. This study aims to examine the connection between cervical vertigo and sociodemographic characteristics, health related lifestyle and certain medication. The background for this study is the hypothesis that subjects with cervical vertigo differentiate in important determinants from subjects without cervical vertigo. Methods: The analyzed data originate from the second follow up of the KORA S4 survey (KORA FF4), a population-based epidemiological study from the year 1999 until 2001. 2279 persons from KORA S4 participated in the KORA FF4 survey from June 2013 until September 2014. For the following study the existence of cervical vertigo for subjects with moderate or heavy dizziness and neck pain while turning their heads at the same time has been assumed (dependent variable). To define the categorical variables, relative and absolute frequencies were used for the definition. Numerical variables were described, depending on the distribution type, with the appropriate position and scattering measures, mean and interquartile range. To investigate the determinants of the occurrence of cervical vertigo, bivariate associations were first calculated. Depending on the data type of the independent variable the t-test or the Pearson's chi-square test has been used. In order to investigate the relationship between potential predictors and cervical vertigo adjusted for possible disturbances, logistic regression models were used. Results: Subjects with cervical vertigo had a mean age from 65.9 years and 74.4% of them were females (control group: 62.0 years, 60.7% female). Per year of life the risk of cervical vertigo increased by 3%. Subjects with cervical vertigo had mainly a less good or poor physical condition. The cervical vertigo subjects were significantly more likely to have moderate to very severe head and back pain than the control subjects (p-value = 0.000). Both, acute cervical disc herniations (9.3%) and acute cervical spine injuries (18.6%) were significantly more frequent in the subjects with cervical vertigo compared to the control group (0.8% / 2.1%). Some medications, such as strong opioids (cervical vertigo (cv): 9.3% / control group (cg): 1.9%), NSAIDs as needed (cv: 48.8% / cg: 15.8%), analgesics (cv: 2.4% / cg: 0.2%), paracetamol regularly (cv: 2.4% / cg: 0.2%) and ibuprofen as needed (cv: 30.2% / cg: 6.4%) were compared to the control group significantly more frequently taken by subjects with cervical dizziness syndrome. Other variables in this study, for example professional qualification or alcohol consumption, showed no statistically significant differences in their incidence between the cervical vertigo group and the control group. Conclusions: In conclusion, this study has shown a statistically significant association between cervical vertigo and the components of age, physical condition, ear pressure, back pain, headache, herniated disc and injuries of the cervical spine and the use of paracetamol, ibuprofen and opioids. In particular, it was able to show the possible existence of a medication-dependent cervical vertigo. Although no reliable diagnosis of a cervical vertigo can be derived retroactively, if cervical vertigo was actually predominantly medication-dependent, this would facilitate the therapeutic treatment of the so-called cervical vertigo and it could be assumed that the primary form of cervical dizziness or vertigo does not exist.
cervical vertigo, cervical dizziness, medication depends
Trybuhl, Christina
2019
German
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Trybuhl, Christina (2019): Determinanten des zervikalen Schwindels. Dissertation, LMU München: Faculty of Medicine
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Abstract

Background: Cervical dizziness or vertigo is defined as dizziness in connection to simultaneous neck pain. After excluding every differential diagnosis for dizziness, in the current state of knowledge, cervical vertigo is traced back to a dysfunction of muscles, joints and ligaments in the cervical spine. This study aims to examine the connection between cervical vertigo and sociodemographic characteristics, health related lifestyle and certain medication. The background for this study is the hypothesis that subjects with cervical vertigo differentiate in important determinants from subjects without cervical vertigo. Methods: The analyzed data originate from the second follow up of the KORA S4 survey (KORA FF4), a population-based epidemiological study from the year 1999 until 2001. 2279 persons from KORA S4 participated in the KORA FF4 survey from June 2013 until September 2014. For the following study the existence of cervical vertigo for subjects with moderate or heavy dizziness and neck pain while turning their heads at the same time has been assumed (dependent variable). To define the categorical variables, relative and absolute frequencies were used for the definition. Numerical variables were described, depending on the distribution type, with the appropriate position and scattering measures, mean and interquartile range. To investigate the determinants of the occurrence of cervical vertigo, bivariate associations were first calculated. Depending on the data type of the independent variable the t-test or the Pearson's chi-square test has been used. In order to investigate the relationship between potential predictors and cervical vertigo adjusted for possible disturbances, logistic regression models were used. Results: Subjects with cervical vertigo had a mean age from 65.9 years and 74.4% of them were females (control group: 62.0 years, 60.7% female). Per year of life the risk of cervical vertigo increased by 3%. Subjects with cervical vertigo had mainly a less good or poor physical condition. The cervical vertigo subjects were significantly more likely to have moderate to very severe head and back pain than the control subjects (p-value = 0.000). Both, acute cervical disc herniations (9.3%) and acute cervical spine injuries (18.6%) were significantly more frequent in the subjects with cervical vertigo compared to the control group (0.8% / 2.1%). Some medications, such as strong opioids (cervical vertigo (cv): 9.3% / control group (cg): 1.9%), NSAIDs as needed (cv: 48.8% / cg: 15.8%), analgesics (cv: 2.4% / cg: 0.2%), paracetamol regularly (cv: 2.4% / cg: 0.2%) and ibuprofen as needed (cv: 30.2% / cg: 6.4%) were compared to the control group significantly more frequently taken by subjects with cervical dizziness syndrome. Other variables in this study, for example professional qualification or alcohol consumption, showed no statistically significant differences in their incidence between the cervical vertigo group and the control group. Conclusions: In conclusion, this study has shown a statistically significant association between cervical vertigo and the components of age, physical condition, ear pressure, back pain, headache, herniated disc and injuries of the cervical spine and the use of paracetamol, ibuprofen and opioids. In particular, it was able to show the possible existence of a medication-dependent cervical vertigo. Although no reliable diagnosis of a cervical vertigo can be derived retroactively, if cervical vertigo was actually predominantly medication-dependent, this would facilitate the therapeutic treatment of the so-called cervical vertigo and it could be assumed that the primary form of cervical dizziness or vertigo does not exist.