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Basilar Invagination

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Symptoms of Basilar Invagination

Symptoms of basilar invagination occur due to pressure on the upper spinal cord or brainstem. Common symptoms include:

  • Posterior headache (pain at the back of the head)
  • Neck weakness
  • Periods of confusion
  • Dysarthria (difficulty swallowing or talking due to loss of muscle control)
  • Dizziness
  • Loss of sensation
  • Cranial nerve disturbance
  • Loss of the ability to know how joints are positioned
  • Lhermitte's sign (an “electric shock” sensation down the spine and/or to the extremities when the neck is flexed forward)
  • Weakness of the arms and legs
  • Orthostatic hypotension (dizziness on standing)


Symptoms may worsen with flexion or extension of the neck. Accurate diagnosis is critical to ensure proper treatment (see Diagnosing and Treating Basilar Invagination).

Complications may include hydrocephaluspseudotumor cerebri, or syringomyelia, because basilar invagination blocks the flow of fluid around the brain and spinal cord.


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Reviewed by Jeffrey Greenfield, Ph.D., M.D. 
Last reviewed/last updated: August 2018