| مستخلص: |
Between 1994-99, two-hundred-twenty-seven motor vehicle collision (MVC) patients with whiplash symptoms including neurologic changes were received for review in a consulting neurology practice. Evaluation of the entire cohort revealed 90% with either a damaged peripheral labyrinth or cochlea; 69% had both. If there had been a loss of consciousness (LOC) noted as a result of the subject MVC, inner ear damage was found in virtually every case. Ninety-two percent (92%) of the patients with inner ear damage met the criteria for a diagnosis of inner ear concussion (IEC); 63% of IEC patients met the diagnostic criteria for benign paroxysmal positional vertigo (BPPV). Sixty-four percent (64%) of IEC cases were diagnosed with secondary endolymphatic hydrops (EH), and 21% were found to have a unior bilateral perilymph fistula (PLF). Most patients with IEC met the diagnostic criterion for more than one subdiagnosis. The patient population was also evaluated for mild neurologic abnormalities by LOC status; 67% of the LOC group exhibited reflex changes versus 32% in the non-LOC group. Cerebellar deficits were observed in 15% of the LOC group, and 8% were seen in the non-LOC group. Aside from VIII cranial nerve disorders, cranial nerve deficits were as follows: V (87% LOC, 58% non-LOC), VII (40% LOC, 28% non-LOC), XII (9% LOC, 12% non-LOC). Cognitive and perceptual difficulties were found concurrently in 95% of LOC cases, and in 79% of the non-LOC cases. The results of the current retrospective analysis suggest that occult vestibular and neurologic disorders are frequently encountered in late whiplash, and that it may be beneficial to investigate such findings in the refractory whiplash case, particularly when there is a history of a loss of consciousness. [ABSTRACT FROM AUTHOR] |
PDF full text from Publisher