[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-209127-en":3,"doc-seo-209127-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},209127,687197207057,"Sage","https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0",7,"Healthcare","Dizziness - Level 3 Upper Quadrant - What Is Causing It?","A clinical overview of dizziness within the “Level 3 Upper Quadrant” framework, outlining a wide differential for the underlying cause. The material organizes potential etiologies across vertebrobasilar or carotid arterial causes, vestibular and cervicogenic sources, concussion/TBI, mental health factors such as anxiety and panic, systemic and neurologic conditions, and medication or medical risk factors. It links patient-reported descriptors to differentiating likely systems, maps which assessments test which system, and provides management pathways for manual therapy, motor control, and vestibular rehabilitation.","DIZZINESS  \nLEVEL 3 UPPER QUADRANT  \nKATE KENNEDY  \nBSCPT, FCAMPT  \n1  \nA PATIENT PRESENTS WITH DIZZINESS – WHAT  \nIS CAUSING IT?  \n2  \nA PATIENT PRESENTS WITH DIZZINESS – WHAT  \nIS CAUSING IT?  \n• VERTEBROBASILAR (OR CAROTID) ARTERIAL SYSTEM  \n• VESTIBULAR (MECHANICAL AND PATHOLOGICAL)  \n• CERVICOGENIC (UPPER C/SPINE VIA TRIGEMINAL NUCLEUS)  \n• CONCUSSION, TBI  \n• MENTAL HEALTH (ANXIETY, DEPRESSION, PANIC)  \n• HYPERVENTILATION  \n• DEHYDRATION  \n• FLU  \n• CNS TUMOUR  \n• SEIZURE DISORDER  \n• VISUAL IMPAIRMENT  \n• CARDIAC  \n• HYPOTENSION  \n• LOSS OF BLOOD VOLUME  \n• STROKE, TIA  \n• CEREBELLAR DISEASE  \n• MS OR OTHER NERVOUS SYSTEM PATHOLOGY  \n• MEDICATIONS  \n• ANEMIA  \n• HYPOGLYCEMIA  \n• CARBON MONOXIDE OR OTHER POISONING  \n• SEVERE ALLERGIES  \n• PREGNANCY  \n• ALTITUDE SICKNESS  \n• THYROID DISORDERS  \n3  \nBUT THAT’S A LONG LIST!  \n4  \nWHEN IS IT RELEVANT FOR ORTHO PHYSIOS?  \n• VERTEBROBASILAR (OR CAROTID) ARTERIAL SYSTEM  \n• VESTIBULAR (MECHANICAL AND PATHOLOGICAL)  \n• CERVICOGENIC (UPPER C/SPINE VIA TRIGEMINAL NUCLEUS)  \n• CONCUSSION, TBI  \n• MENTAL HEALTH (ANXIETY, DEPRESSION, PANIC)  \n• HYPERVENTILATION  \n• DEHYDRATION  \n• FLU  \n• CNS TUMOUR  \n• SEIZURE DISORDER  \n• VISUAL IMPAIRMENT  \n• CARDIAC  \n• HYPOTENSION  \n• LOSS OF BLOOD VOLUME  \n• STROKE, TIA  \n• CEREBELLAR DISEASE  \n• MS OR OTHER NERVOUS SYSTEM PATHOLOGY  \n• MEDICATIONS  \n• ANEMIA  \n• HYPOGLYCEMIA  \n• CARBON MONOXIDE OR OTHER POISONING  \n• SEVERE ALLERGIES  \n• PREGNANCY  \n• ALTITUDE SICKNESS  \n• THYROID DISORDERS  \n5  \nWHAT SUBJECTIVE DESCRIPTORS WILL HELP YOU DIFFERENTIATE THE CAUSE?  \n| Vascular (VBI) |  |\n| --- | --- |\n| Vestibular |  |\n\n6  \nWHAT SUBJECTIVE DESCRIPTORS WILL HELP YOU DIFFERENTIATE THE CAUSE?  \n\n| Cervicogenic – articular, muscular |  |\n| --- | --- |\n| Cervicogenic – somatosensory |  |\n\n7  \nWHAT SUBJECTIVE DESCRIPTORS WILL HELP YOU DIFFERENTIATE THE CAUSE?  \n\n| Concussion |  |\n| --- | --- |\n| Other |  |\n\n8  \nFROM OUR SCAN, WHICH TESTS ASSESS WHICH SYSTEM?  \n|  | \u003Cbr>Vascular | \u003Cbr>Vestibular | Cervicogenic | \u003Cbr>Concussion | \u003Cbr>Other |\n| --- | --- | --- | --- | --- | --- |\n| Cspine AROM |  |  |  |  |  |\n| Neuro (seg, UMNL)\u003Cbr>|  |  |  |  |  |\n| Cranial n’s\u003Cbr>|  |  |  |  |  |\n| CV stability\u003Cbr>|  |  |  |  |  |\n| Carotid pulse\u003Cbr>|  |  |  |  |  |\n| Hautard’s\u003Cbr>|  |  |  |  |  |\n\n9  \nWHAT FURTHER TESTING IS REQUIRED?  \n\n| Vascular | Vestibular | Cervicogenic | Concussion | Other |\n| --- | --- | --- | --- | --- |\n|  |  |  |  |  |\n\n10  \n\n| CAN WE DIFFERENTIATE\u003Cbr>WITH CONFIDENCE? |  | |\n| --- | --- | --- |\n| | [Madaboutmemes.com](Madaboutmemes.com) |  |\n\n11  \nMANAGEMENT  \n• IF MANUAL THERAPY IS INDICATED:  \n• JOINT MOBILIZATION INCLUDING SNAGS  \n• SOFT TISSUE TECHNIQUES  \n• NEURAL/DURAL MOBILIZATION  \n[mulliganconcept.files.wordpress.com](mulliganconcept.files.wordpress.com)  \nJack Miller digitalconcepts  \nSA Reid, et al. (2008) Manual Therapy 13:357–366 [cmdtherapy.com](cmdtherapy.com)  \n12  \nMANAGEMENT  \n• IF MOTOR CONTROL IS INDICATED:  \n• DEEP NECK FLEXOR AND EXTENSOR ACTIVATION  \n• POSTURAL CORRECTION  \n• STRENGTH AND ENDURANCE  \n• KINAESTHETIC AWARENESS – NEUTRAL REPOSITIONING, EYE MOVEMENT CONTROL, ACTIVE  \nSEGMENTAL FLEXION/EXTENSION/ROTATION  \n• BALANCE RETRAINING (POSTURAL SWAY)  \n[sprintphysio.co.uk](sprintphysio.co.uk)  \n[Cottesloephysiotherapy.com.au](Cottesloephysiotherapy.com.au)  \n13  \nMANAGEMENT  \n• IF VESTIBULAR REHABILITATION IS INDICATED:  \n• SEVERAL MOVEMENT RELATED MANEUVERS MAYBE RELEVANT  \n• GAZE STABILIZATION  \n• MOTION HABITUATION EXERCISE  \n• BALANCE, POSTURAL SWAY  \n[fabhow.com](fabhow.com)  \n[dartmouth-hitchcock.org](dartmouth-hitchcock.org)  \nBell, DR et al (2011) Sports Health  \n14  \nSELECT REFERENCES  \n• HUTTING, N., ANTONIUS, H., & KERRY, R. (2020). YES, WE SHOULD ABANDON PRE-TREATMENT POSITIONAL TESTING OF THE CERVICAL SPINE. MUSCULOSKELETAL SCIENCE AND PRACTICE, 49, 102181.  \n• REID SA, ET AL. (2008) SUSTAINED NATURAL APOPHYSEAL GLIDES (SNAGS) ARE AN EFFECTIVE TREATMENT FOR CERVICOGENIC DIZZINESS. MANUAL THERAPY 13:3","cbCaipNdBnKoRwOI","https://ap.wps.com/l/cbCaipNdBnKoRwOI","pdf",788354,1,8,"English","en",105,"# A Patient Presents With Dizziness - What Is Causing It?\n## Possible causes across systems\n## When is it relevant for ortho physios?\n## Subjective descriptors to differentiate the cause\n## Tests and further assessment\n# Management\n## Manual therapy when indicated\n## Motor control when indicated\n## Vestibular rehabilitation when indicated\n# Select references","[{\"question\":\"What main categories of causes are listed for patient dizziness?\",\"answer\":\"The slides group causes into vertebrobasilar (or carotid) arterial system, vestibular (mechanical and pathological), cervicogenic (upper C/spine via trigeminal nucleus), concussion/TBI, mental health (anxiety, depression, panic), and additional medical causes such as dehydration, cardiac issues, hypotension, stroke/TIA, medications, anemia, hypoglycemia, and thyroid disorders.\"},{\"question\":\"Which subjective descriptors help differentiate the likely dizziness system?\",\"answer\":\"The content highlights subjective descriptors that distinguish vascular/vestibular patterns, cervicogenic subtypes (articular/muscular and somatosensory), and concussion versus other causes.\"},{\"question\":\"How does the document guide testing and management after identifying the system?\",\"answer\":\"It maps which tests assess which system (e.g., cervical spine AROM, neurologic segment and UMNL, cranial nerves, CV stability, carotid pulse, and Hautard’s). Management then branches into manual therapy, motor control (deep neck flexor/extensor activation, postural correction, strengthening, and balance retraining), or vestibular rehabilitation with movement, gaze stabilization, and habituation exercises.\"}]","Dizziness - Level 3 Upper Quadrant - What Is Causing It? | PDF",1788609836,20,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":28},"dizziness-level-3-upper-quadrant-what-is-causing-it","",{"@graph":36,"@context":85},[37,54,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/dizziness-level-3-upper-quadrant-what-is-causing-it/209127/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":62,"encodingFormat":61,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-09-05",true,{"@type":65,"interactionType":66,"userInteractionCount":4},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"What main categories of causes are listed for patient dizziness?","Question",{"text":75,"@type":76},"The slides group causes into vertebrobasilar (or carotid) arterial system, vestibular (mechanical and pathological), cervicogenic (upper C/spine via trigeminal nucleus), concussion/TBI, mental health (anxiety, depression, panic), and additional medical causes such as dehydration, cardiac issues, hypotension, stroke/TIA, medications, anemia, hypoglycemia, and thyroid disorders.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"Which subjective descriptors help differentiate the likely dizziness system?",{"text":80,"@type":76},"The content highlights subjective descriptors that distinguish vascular/vestibular patterns, cervicogenic subtypes (articular/muscular and somatosensory), and concussion versus other causes.",{"name":82,"@type":73,"acceptedAnswer":83},"How does the document guide testing and management after identifying the system?",{"text":84,"@type":76},"It maps which tests assess which system (e.g., cervical spine AROM, neurologic segment and UMNL, cranial nerves, CV stability, carotid pulse, and Hautard’s). Management then branches into manual therapy, motor control (deep neck flexor/extensor activation, postural correction, strengthening, and balance retraining), or vestibular rehabilitation with movement, gaze stabilization, and habituation exercises.","https://schema.org",{"og:url":52,"og:type":87,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":89,"canonical":52},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":92},[93,97,101,105,110,115,118,122,126,129,133],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":98,"show_sort_weight":99,"slug":100},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":46,"category_name":102,"show_sort_weight":103,"slug":104},"Exam",70,"exam",{"id":106,"doc_module":4,"doc_module_name":46,"category_name":107,"show_sort_weight":108,"slug":109},5,"Comic",60,"comic",{"id":111,"doc_module":4,"doc_module_name":46,"category_name":112,"show_sort_weight":113,"slug":114},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":116,"slug":117},40,"healthcare",{"id":21,"doc_module":4,"doc_module_name":46,"category_name":119,"show_sort_weight":120,"slug":121},"Research & Report",30,"research-report",{"id":123,"doc_module":4,"doc_module_name":46,"category_name":124,"show_sort_weight":29,"slug":125},9,"Religion & Spirituality","religion-spirituality",{"id":29,"doc_module":4,"doc_module_name":46,"category_name":127,"show_sort_weight":29,"slug":128},"World Cup","world-cup",{"id":130,"doc_module":4,"doc_module_name":46,"category_name":131,"show_sort_weight":130,"slug":132},10,"Lifestyle","lifestyle",{"id":134,"doc_module":4,"doc_module_name":46,"category_name":135,"show_sort_weight":106,"slug":136},19,"General","general"]