The results of 18 greater occipital nerve release operations in 13 patients were analyzed. All patients had deep aching pain in the occipital area due to a whiplash trauma, and in all cases the pain was relieved temporarily by local anesthesia of the occipital nerve. The time from accident to operation was 6 to 96 months. The results of 13 (72.2%) operations were reported as good or excellent, although complete pain relief was not attained in any patient. It is concluded that neurolysis of the greater occipital nerve after whiplash injury can give meaningful pain relief in selected patients.

Thirty-eight patients with late whiplash syndrome were investigated with regard to symptoms which conform with the criteria for other specific diagnoses. All had pain and tender points in the neck and 37 (97.4%) suffered from headache. Seven patients (18.4%) had occipital neuralgia in accordance with the IHS criteria and 16 (42.1%) if the IASP criteria were used. Four patients (10.5%) had oromandibular dysfunction, 20 (52.6%) had periarticular shoulder disorder, and 12 (31.6%) had thoracic outlet syndrome. Five (13.2%) had chronic mechanical low back pain and two (5.3%) segmental instability of the lumbar spine. Four (10.5%) had symptoms concurring with the diagnosis of fibromyalgia. It is concluded that many of the symptoms of patients that suffer from late whiplash syndrome conform with the criteria of other specific diagnoses.

Pure alexia is unusual in MS and to our knowledge only 1 other case has been reported (in Japanese). Memory impairments and slowed information processing are probably the most frequent cognitive sequelae of the disease and, consequently, the literature is biased toward the study of those cognitive domains. However, given the wide distribution of sclerotic plaques in MS, it could be argued that we should expect some variability of cognitive changes in MS. Striking deficits as seen in this patient should make us more sensitive to this possibility.

No abstract