Sudden onset vomiting and vertigo following chiropractic neck manipulation.

Accepted 10 March 1998 A previously healthy 38-year-old woman presented to her chiropractor with a 2-week history of right neck pain with radiation to the right occipital area. The pain was exacerbated by neck extension and rapid lateral movements of the neck. It was temporarily relieved by paracetamol. There had been no history of neck trauma. The chiropractor noted that cervical rotation to the left and neck extension reproduced her right sub-occipital pain. The chiropractor then proceeded to neck manipulation which involved sudden lateral flexion 'adjustments' Immediately after this procedure the patient ~ ~ ~ began to feel vaguely unwell with an increase in _ the right neck pain. After 5 minutes the patient was helped into a sitting position and started to ~~1~~ experience true vertigo shortly followed by profuse vomiting. When the vomiting had not sub . sided after several minutes the patient was transferred to the Accident and Emergency :M-----------