domingo, 28 de agosto de 2011
Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?
Authors
Francesco Dispenza MDa, Alessandro De Stefano MDb, Navneet Mathur MSc, Adelchi Croce MDb and Salvatore Gallina MD, PhDd
a Dipartimento Discipline Chirurgiche ed Oncologiche–UO Otorinolaringoiatria, Università degli Studi di Palermo, Italia
b Dipartimento di Scienze Chirurgiche, Sperimentali e Cliniche–UO Otorinolaringoiatria, Università degli Studi “G. d'Annunzio” Chieti-Pescara, Italia
c RNT Medical College, Udaipur, India
d Dipartimento Neuroscienze Cliniche–UO Otorinolaringoiatria, Università degli Studi di Palermo, Italia
Abstract
Objective
The aim of the study was to evaluate the true incidence, diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV) arising after whiplash injury and to distinguish this type of posttraumatic vertigo from other types of dizziness complained after trauma.
Methods
This was a retrospective study comprising patients referred to our center after whiplash injury. The patients were evaluated with neurotologic examination including bedside and instrumental tests. A Dizziness Handicap Inventory evaluating the symptoms of patients was submitted before and after treatment and was evaluated. The BPPV patients were separately evaluated from those with cervicogenic vertigo, and a comparison between our data about idiopathic BPPV was done.
Results
Eighteen patients of whiplash who had BPPV were evaluated.
The mean age was 38.2 years.
BPPV was the cause of vertigo in 33.9% of total whiplash patients.
In 16 cases, the posterior semicircular canal was involved; the lateral semicircular canal was involved in 2 cases.
The instrumental neurotologic assessment did not show any alteration of either vestibulospinal reflexes or dynamic ocular movements.
Duration of symptoms before treatment ranged from 3 to 26 days.
A total of 55.5% of patients had relief from their symptoms after first repositioning maneuver.
The Dizziness Handicap Inventory score improved in all patients treated with repositioning maneuvers, but no difference emerged with idiopathic BPPV data.
Conclusion
BPPV after whiplash injury could be unveiled with a simple bedside examination of peripheral vestibular system, and a treatment could be done in the same session.
The diagnosis of posttraumatic BPPV is not different from the idiopathic form, but the treatment may require more maneuvers to achieve satisfactory results.
Corresponding Author Contact Information Corresponding author.
Dipartimento Discipline Chirurgiche ed Oncologiche–UO Otorinolaringoiatria, Università degli Studi di Palermo,
Via Paolo Emiliani Giudici 37, 90127
Palermo–Italy. Tel.: +393334565471.
fuente
: American Journal of Otolaryngology
Volume 32, Issue 5, September-October 2011, Pages 376-380
Volume 32, Issue 5, September-October 2011, Pages 376-380
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A whiplash injury can be sustained in after accident, it is a neck injury caused by a sudden movement of the head forwards, backwards or sideways. Whiplash claim solicitors usually handles such cases obviously. In the UK, car accident is the most common reason that they make claim, 400,000 car accidents happen every year and they cost the NHS over £470million.
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