Dizziness is not diagnosticBMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39156.530949.FA (Published 22 March 2007) Cite this as: BMJ 2007;334:600
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Thoracic Outlet Syndrome(TOS) causes dizziness because of
positional compression of the vertebral artery with resultant symptoms of
vertebrobasilary insufficiency. Compression of C7,C8,and T1 nerves fibers
is responsible for the neck pain.
The diagnosis of TOS should be performed
in all patients complaining of dizziness and or neck pain; because TOS may
be partially or totally responsible for the symptoms attributed to another
pathology. The clinical diagnosis of TOS is made by the use of a Diagnostic
Triad in the physical examination: 1) weakness of abduction and adduction
of the fifth finger(C8,
T1). 2) Tireness,paresthesias of the upper extremity on elevation of the
hands pointing to the ceiling. Associated or not with paleness of the
hands; extreme paleness is called the White Hand Sign. 3) tenderness on
thumb pressure in the supraclvicular area.(See www.tos-syndrome.com).
cervical spine Xrays reports should include the anomalies of the
transverse process of the 7th cervical vertebra:
elongation, enlargement, downwards beaking; because they are commonly present
in patients with TOS who had a positive triad. In the cervical spine
radiological picture shown in the paper there is a elongated transverse
process of the 7th cervical vertebra seen.
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Competing interests: No competing interests