A 72-year-old female presented to CFNC with a chief complaint of dizziness and vertigo-like symptoms and associated suboccipital neuralgia.
Symptoms started after traveling on an airplane and were dismissed for signs of fatigue and jet lag. As time went on, the symptoms persisted and progressed. The dizziness could be recreated when turning over in bed to start the day or when bending forward and standing back up. The sensation was described as an inner feeling of swirling (moving in a circular pattern).
The patient had been told previously that she was experiencing cervical vertigo that had been caused by an earlier motor vehicle accident with associated whiplash, as well as contributing factors from unmanaged concussions.
Examination and Diagnosis
Physical examination and diagnostic testing revealed global gaze instability, impaired pursuit mechanisms and negative head thrust (impaired vestibulo-ocular reflex). The patient was diagnosed with cervicogenic dizziness. Neurological examination revealed involvement of the patient’s bilateral pontomedullary reticular formation, midline cerebellar and musculoskeletal.
The patient was initially treated two times per week for one hour over six consecutive weeks (12 visits total), with a re-examination on the final visit. After re-examination, the patient was recommended to follow up for 30-minute sessions every three to four weeks to maintain current progress and check in.
Treatment consisted of vestibular rehabilitation and oculomotor exercises, red light therapy, Rezzimax Tuner Pro, electrical stimulation, percussor and brainstem neuromodulation through RPSS.
After the initial course of treatment, the patient was no longer experiencing dizziness, noticed reduced pain in the cervical region and no longer felt the need to ice the area on a consistent basis. The patient was sent to a local functional medicine practitioner for further co-management of headaches and chronic fatigue syndrome.
Functional neurological care and red light therapy have been shown to be effective in the treatment of cervicogenic dizziness. Patients require an individualized approach and targeted treatment to achieve optimal results.