A 41-year-old woman presents 4 months after a rear-end motor vehicle collision. She reports a persistent floating, light-headed sensation triggered by neck movement, particularly turning her head while driving. She has neck pain and limited cervical range of motion. There is no true spinning vertigo. Bedside examination shows no spontaneous nystagmus, normal HIT, normal calorics, normal smooth pursuit and saccades. MRI brain and cervical spine are unremarkable apart from mild disc-bulge findings consistent with her age.
CDP findings
SOT pattern vs normalMCT — medium-amplitude backward translationADT — sway energy across five trials per direction
Audiometric findings
Normal hearing — both ears within 20 dB HL across all frequencies.
Healthy adult audiogram. Thresholds sit within the 0–20 dB HL normal range across all tested frequencies, with the small high-frequency rise typical of healthy adults. Paired with a normal CDP, this is the unremarkable baseline.
Single-best-answer
Her CDP is essentially normal. How should this be interpreted and the patient managed?
Teaching point. Cervicogenic dizziness is a diagnosis of exclusion: motion-provoked, non-spinning dizziness in the context of cervical spine pathology, with a normal vestibular work-up. CDP is typically normal because the test probes quiet stance, not head-on-neck movement. Management is cervical physiotherapy. The disorder commonly coexists with PPPD, and both may need addressing together.