Summary by Utah Sports and Wellness

Link to Original Article:

  • Manual Medicine, 1983
  • Hulse


In primates, equilibrium (subjective orientation in space) requires both an intact peripheral apparatus, vestibular nerve, and/or the vestibular nuclei, and upper cervical spine somatosensory integration.

  • Disequilibrium is an ontological or oto-neurological problem.
  • Disequilibrium may be caused by destruction in the peripheral vestibular apparatus, the vestibular nerve and/or the vestibular nuclei.
  • Patients suffering from bilateral failure of the vestibular system occurs when damaged through streptomycin.
  • The importance of the proprioceptors in the cervical region is clearly demonstrated by locally blocking the receptors with anesthetics.

One third of the functional disturbance in the upper cervical spine of all patients can be attributed to trauma.

  • Functional Disturbance of the Upper Cervical Spine can be observed with cranial trauma.
  • The most prevalent subjective symptom is headache in the neck and occipital region.
  • All cervical syndromes have in common symptoms of vertigo either of sudden onset or definite increase in strength caused by motion of the head and/or a specific head position.

Proprioceptive Cervical Nystagmus vs. Vascular Cervical Nystagmus

  • Proprioceptive: Occurs during body rotation, has no latent period, and always noted in different directions of cervical motions.
  • Vascular: Usually only occurs with minimal neck damage, has a latent period ranging from 3-50 seconds, and usually only in one direction.

The normalization of the hearing ability would indicate the manual therapy influences hearing difficulties and therefore contradicts experiences described in the literature.