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Neurology of Whiplash

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Whiplash Injuries
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Abstract

Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck which may result mainly from rear-end or side-impact motor vehicle collisions but also from diving or other mishaps [1]. Whiplash-associated disorder (WAD) is generally considered to be a soft tissue injury of the neck with symptoms such as neck pain and stiffness, headaches, cognitive and psychiatric disorders, dizziness, visual symptoms, paresthesias, and weakness. It is estimated that the incidence of whiplash injury is approximately 4 per 1,000 persons [2]. Although many persons involved in whiplash injuries recover quickly, between 4 and 42 % of patients report symptoms several years later [2, 3]. According to Quebec Task Force, late whiplash syndrome has been defined by the symptoms persistence for more than 6 months after the injury. Patients with neurological symptoms caused by whiplash syndrome are frequently referred to neurologists in everyday clinical practice.

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References

  1. Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, Zeiss E (1995) Scientific monograph of Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine 20(8 Suppl):1–73

    Google Scholar 

  2. Eck JC, Hodges SD, Humphreys SC (2001) Whiplash: a review of a commonly misunderstood injury. Am J Med 110:651–656

    Article  CAS  PubMed  Google Scholar 

  3. Radanov BP, Sturzenegger M, DiStefano G (1995) Long-term outcome after whiplash injury. Medicine 74:281–297

    Article  CAS  PubMed  Google Scholar 

  4. Sjaastad O, Fredriksen T, Bakketeig L (2009) Headache subsequent to whiplash. Curr Pain Headache Rep 13(1):52–58

    Article  PubMed  Google Scholar 

  5. Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders: 2nd edition. Cephalalgia 24(1 Suppl):9–160

    Google Scholar 

  6. Schrader H, Stovner LJ, Obelieniene D, Surkiene D, Mickeviciene D, Bovim G, Sand T (2006) Examination of the diagnostic validity of ‘headache attributed to whiplash injury’: a controlled, prospective study. Eur J Neurol 13(11):1226–1232

    Article  CAS  PubMed  Google Scholar 

  7. Stovner LJ, Obelieniene D (2008) Whiplash headache is transitory worsening of a pre-existing primary headache. Cephalalgia 28(Suppl 1):28–31

    Article  PubMed  Google Scholar 

  8. Epstein JB, Klasser GD (2011) Whiplash-associated disorders and temporomandibular symptoms following motor-vehicle collisions. Quintessence Int 42(1):e1–e14

    PubMed  Google Scholar 

  9. Magnússon T, Ragnarsson T, Björnsson A (1996) Occipital nerve release in patients with whiplash trauma and occipital neuralgia. Headache 36(1):32–36

    Article  PubMed  Google Scholar 

  10. Bogduk N, Marsland A (1986) On the concept of third occipital headache. J Neurol Neurosurg Psychiatry 49(7):775–780

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Lord SM, Barnsley L, Wallis BJ, Bogduk N (1994) Third occipital nerve headache: a prevalence study. J Neurol Neurosurg Psychiatry 57(10):1187–1190

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Kischka U, Ettlin TH, Heim S (1991) Cerebral symptoms following whiplash injury. Eur Neurol 31:136–140

    Article  CAS  PubMed  Google Scholar 

  13. Robinson JP, Burwinkle T, Turk DC (2007) Perceived and actual memory, concentration, and attention problems after whiplash-associated disorders (grades I and II): prevalence and predictors. Arch Phys Med Rehabil 88(6):774–779

    Article  PubMed  Google Scholar 

  14. Di Stefano G, Radanov BP (1996) Quantitative and qualitative aspects of learning and memory in common whiplash patients: a 6-month follow-up study. Arch Clin Neuropsychol 11:661–676

    Article  Google Scholar 

  15. Radanov BP, Di Stefano G, Schnidrig A, Sturzenegger M (1994) Common whiplash: psychosomatic or somatopsychic? J Neurol Neurosurg Psychiatry 57:486–490

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Guez M, Brannstrom R, Nyberg L, Toolanen G, Hildingsson C (2005) Neuropsychological functioning and MMPI-2 profiles in chronic neck pain: a comparison of whiplash and non-traumatic groups. J Clin Exp Neuropsychol 27:151–163

    Article  PubMed  Google Scholar 

  17. Sturzenegger M, Radanov BP, Winter P, Simko M, Farra AD, Di Stefano G (2008) MRI-based brain volumetry in chronic whiplash patients: no evidence for traumatic brain injury. Acta Neurol Scand 117(1):49–54

    CAS  PubMed  Google Scholar 

  18. Otte A, Ettlin TM, Nitzsche EU, Wachter K, Hoegerle S, Simon GH, Fierz L, Moser E, Mueller-Brand J (1997) PET and SPECT in whiplash syndrome: a new approach to a forgotten brain? J Neurol Neurosurg Psychiatry 63(3):368–372

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Bicik I, Radanov BP, Schäfer N, Dvorak J, Blum B, Weber B, Burger C, Von Schulthess GK, Buck A (1998) PET with 18fluorodeoxyglucose and hexamethylpropylene amine oxime. SPECT in late whiplash syndrome. Neurology 51(2):345–350

    Article  CAS  PubMed  Google Scholar 

  20. Radanov BP, Sturzenegger M, De Stefano G, Schnidrig A (1994) Relationship between early somatic, radiological, cognitive and psychosocial findings and outcome during a one-year follow-up in 117 patients suffering from common whiplash. Br J Rheumatol 33:442–448

    Article  CAS  PubMed  Google Scholar 

  21. Magnusson T (1994) Extracervical symptoms after whiplash trauma. Cephalalgia 14:223–227

    Article  CAS  PubMed  Google Scholar 

  22. Schlesinger I, Hering-Hanit R, Dagan Y (2001) Sleep disturbances after whiplash injury: objective and subjective findings. Headache 41(6):586–589

    Article  CAS  PubMed  Google Scholar 

  23. Valenza MC, Valenza G, González-Jiménez E, De-la-Llave-Rincón AI, Arroyo-Morales M, Fernández-de-Las-Peñas C (2012) Alteration in sleep quality in patients with mechanical insidious neck pain and whiplash-associated neck pain. Am J Phys Med Rehabil 91(7):584–591

    Article  PubMed  Google Scholar 

  24. Mayou R, Bryant B (2002) Psychiatry of whiplash neck injury. Br J Psychiatry 180:441–448

    Article  PubMed  Google Scholar 

  25. Wenzel HG, Haug TT, Mykletun A, Dahl AA (2002) A population study of anxiety and depression among persons who report whiplash traumas. J Psychosom Res 53(3):831–835

    Article  PubMed  Google Scholar 

  26. Mykletun A, Glozier N, Wenzel HG, Overland S, Harvey SB, Wessely S, Hotopf M (2011) Reverse causality in the association between whiplash and symptoms of anxiety and depression: the HUNT study. Spine 36(17):1380–1386

    Article  PubMed  Google Scholar 

  27. Treleaven J, Jull G, Sterling M (2003) Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. J Rehabil Med 35:36–43

    Article  PubMed  Google Scholar 

  28. Dispenza F, De Stefano A, Mathur N, Croce A, Gallina S (2011) Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality? Am J Otolaryngol 32(5):376–380

    Article  PubMed  Google Scholar 

  29. Treleaven J (2011) Dizziness, unsteadiness, visual disturbances, and postural control: implications for the transition to chronic symptoms after a whiplash trauma. Spine 36(25 Suppl):211–217

    Article  Google Scholar 

  30. Endo K, Ichimaru K, Komagata M, Yamamoto K (2006) Cervical vertigo and dizziness after whiplash injury. Eur Spine J 15(6):886–890

    Article  PubMed Central  PubMed  Google Scholar 

  31. Barré JA (1926) Sur un syndrome sympathique cervical postérieur et sa cause frequente, l’arthrite cervicale. Rev Neurol (Paris) 1:1246–1248

    Google Scholar 

  32. Yacovino DA (2012) Cervical vertigo: myths, facts, and scientific evidence. Neurología. doi:10.1016/j.nrl.2012.06.013

  33. Chetana N, Claussen CF (2010) Vertigo in whiplash injury: a presentation of prevalent butterfly patterns of caloric tests. Indian J Otolaryngol Head Neck Surg 62(2):208–214

    Article  PubMed Central  PubMed  Google Scholar 

  34. Treleaven J, Jull G, Grip H (2011) Head eye co-ordination and gaze stability in subjects with persistent whiplash associated disorders. Man Ther 16(3):252–257

    Article  PubMed  Google Scholar 

  35. Gimse R, Bjørgen IA, Straume A (1997) Driving skills after whiplash. Scand J Psychol 38(3):165–170

    Article  CAS  PubMed  Google Scholar 

  36. Mosimann UP, Muri RM, Felblinger J, Radanov PB (2000) Saccadic eye movement disturbances in whiplash patients with persistent complaints. Brain 123:828–835

    Article  PubMed  Google Scholar 

  37. Treleaven J, Jull G, LowChoy N (2005) Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. J Rehabil Med 37(4):219–223

    Article  PubMed  Google Scholar 

  38. Brown S (2003) Effect of whiplash injury on accommodation. Clin Experiment Ophthalmol 31(5):424–429

    Article  PubMed  Google Scholar 

  39. Heikkila HV, Wenngren BI (1998) Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury. Arch Phys Med Rehabil 79(9):1089–1094

    Article  CAS  PubMed  Google Scholar 

  40. Burke JP, Orton HP, West J, Strachan IM, Hockey MS, Ferguson DG (1992) Whiplash and its effect on the visual system. Graefes Arch Clin Exp Ophthalmol 230(4):335–339

    Article  CAS  PubMed  Google Scholar 

  41. Norris SH, Watt I (1983) The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone Joint Surg Br 65(5):608–611

    CAS  PubMed  Google Scholar 

  42. Evans RW (2006) Whiplash injuries. In: Evans RW (ed) Neurology and trauma. WB Saunders, Philadelphia, pp 425–449

    Google Scholar 

  43. Roos DB, Owens JC (1966) Thoracic outlet syndrome. Arch Surg 93:71–74

    Article  CAS  PubMed  Google Scholar 

  44. Capistrant TD (1986) Thoracic outlet syndrome in cervical strain injury. Minn Med 69:13–17

    CAS  PubMed  Google Scholar 

  45. Kai Y, Oyama M, Kurose S, Inadome T, Oketani Y, Masuda Y (2001) Neurogenic thoracic outlet syndrome in whiplash injury. J Spinal Disord 14(6):487–493

    Article  CAS  PubMed  Google Scholar 

  46. Omar N, Alvi F, Srinivasan MS (2007) An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury. Eur Spine J 16(3 Suppl):275–277

    Article  PubMed Central  PubMed  Google Scholar 

  47. Bodack MP, Tunkel RS, Marini SG, Nagler W (1998) Spinal accessory nerve palsy as a cause of pain after whiplash injury: case report. J Pain Symptom Manage 15(5):321–328

    Article  CAS  PubMed  Google Scholar 

  48. Gupta V, Posner B (2004) Trauma to the long thoracic nerve and associated scapula winging in a low-velocity rear-end automobile collision: case report. J Trauma 57(2):402–403

    Article  PubMed  Google Scholar 

  49. Panjabi MM, Maak TG, Ivancic PC, Ito S (2006) Dynamic intervertebral foramen narrowing during simulated rear impact. Spine 31(5):E128–E134

    Article  PubMed  Google Scholar 

  50. Tominaga Y, Maak TG, Ivancic PC, Panjabi MM, Cunningham BW (2006) Head-turned rear impact causing dynamic cervical intervertebral foramen narrowing: implications for ganglion and nerve root injury. J Neurosurg Spine 4(5):380–387

    Article  PubMed  Google Scholar 

  51. Ito S, Panjabi MM, Ivancic PC, Pearson AM (2004) Spinal canal narrowing during simulated whiplash. Spine 29:1330–1339

    Article  PubMed  Google Scholar 

  52. Ivancic PC (2012) Cervical neural space narrowing during simulated rear crashes with anti-whiplash systems. Eur Spine J 21(5):879–886

    Article  PubMed Central  PubMed  Google Scholar 

  53. Kasch H, Bach FW, Jensen TS (2001) Handicap after acute whiplash injury: a 1-year prospective study of risk factors. Neurology 56:1637–1643

    Article  CAS  PubMed  Google Scholar 

  54. Prushansky T, Gepstein R, Gordon C, Dvir Z (2005) Cervical muscles weakness in chronic whiplash patients. Clin Biomech (Bristol, Avon) 20(8):794–798

    Article  Google Scholar 

  55. Ulbrich EJ, Aeberhard R, Wetli S, Busato A, Boesch C, Zimmermann H, Hodler J, Anderson SE, Sturzenegger M (2012) Cervical muscle area measurements in whiplash patients: acute, 3, and 6 months of follow-up. J Magn Reson Imaging 36(6):1413–1420

    Article  PubMed  Google Scholar 

  56. Aniss AM, Gandevia SC, Milne RJ (1988) Changes in perceived heaviness and motor commands produced by cutaneous reflexes in man. J Physiol 397:113–126

    PubMed Central  CAS  PubMed  Google Scholar 

  57. Cassidy JD, Carroll LJ, Côté P, Lemstra M, Berglund A, Nygren A (2000) Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med 342(16):1179–1186

    Article  CAS  PubMed  Google Scholar 

  58. Spearing NM, Connelly LB (2011) Whiplash and the compensation hypothesis. Spine 36(25 Suppl):303–308

    Article  Google Scholar 

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Meola, G., Bugiardini, E., Scelzo, E. (2014). Neurology of Whiplash. In: Alpini, D., Brugnoni, G., Cesarani, A. (eds) Whiplash Injuries. Springer, Milano. https://doi.org/10.1007/978-88-470-5486-8_6

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  • DOI: https://doi.org/10.1007/978-88-470-5486-8_6

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