A comparison of symptoms experienced following minor head injury and acute neck strain (whiplash injury).

Barrett, Ken; Buxton, Neil; Redmond, A D; Jones, Jared; Boughey, A.; Ward, Anthony B.

doi:10.1136/emj.12.3.173

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…All three groups of subjects reported a disturbance of cognition (difficulty concentrating) to various degrees. This is consistent with previous literature that documents disturbance of cognition in all three groups . Our vestibular subjects reported a disturbance of concentration much less commonly than did our cervical and migraine subjects.…”

Section: Discussionsupporting

confidence: 93%

“…This is consistent with previous literature that documents disturbance of cognition in all three groups. [37][38][39][40] Our vestibular subjects reported a disturbance of concentration much less commonly than did our cervical and migraine subjects. Twenty-seven percent of our cervical vertigo subjects complained of vertigo-ie, spinning sensations.…”

Section: Discussionmentioning

confidence: 52%

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Symptoms in cervical vertigo

Thompson‐Harvey

Hain

2018

Laryngoscope Investig Oto

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Objective To use a unique, 41‐question survey to identify patient features distinguishing cervical vertigo from vestibular causes of vertigo and vestibular migraine. Methods In this study, a unique, 41‐question survey was administered to 48 patients diagnosed with cervical vertigo (n = 16), migraine (n = 16), and vestibular vertigo (eg, unilateral vestibular paresis, Meniere's disease) (n = 16) to test the hypothesis that a set of distinct symptoms can characterize cervical vertigo. Responses between the three diagnostic groups were compared to identify questions which differentiated patients based on their symptoms. Results Eight questions were successful in differentiating vestibular vertigo from migraine and cervical vertigo. Symptoms endorsed by subjects with cervical vertigo overlapped substantially with subjects with well‐established vestibular disturbances as well as symptoms of subjects with migraine. Twenty‐seven percent of cervical vertigo subjects reported having true vertigo, 50% having headache, and 94% having neck pain. Conclusion Lacking knowledge of neck disturbance, the symptoms we elicited in our questionnaire suggest that cervical vertigo subjects may resemble migraine subjects who also have evidence of neck injury. Whether or not subjects with “cervical vertigo” also overlap with other diagnoses defined by a combination of symptoms and exclusion of objective findings such as chronic subjective dizziness and other variants of psychogenic dizziness remain to be established. Level of Evidence IV

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 52%

Symptoms in cervical vertigo

Thompson‐Harvey

Hain

2018

Laryngoscope Investig Oto

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“…Anxiety, depression and benefit receipt were the covariates separately attenuating the association between chronic whiplash and somatic symptoms the most. The increased load of symptoms of anxiety and depression found among individuals reporting a whiplash injury, is in line with previous studies [ 3 , 13 , 15 , 21 ]. Two explanations have been given for the increased level of anxiety and depression seen in chronic whiplash: It has been considered a psychological response to the injury, like in post-traumatic stress disorder, or as a response to physical pain resulting from the injury [ 74 ].…”

Section: Discussionsupporting

confidence: 92%

“…In the acute phase after a whiplash injury, lasting up to four weeks, the most common symptoms are pain and stiffness of the neck and headache [ 3 , 4 ]. The condition is usually benign and the majority of patients rapidly recover [ 4 - 6 ].…”

Section: Introductionmentioning

confidence: 99%

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

et al. 2012

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BackgroundChronic whiplash leads to considerable patient suffering and substantial societal costs. There are two competing hypothesis on the etiology of chronic whiplash. The traditional organic hypothesis considers chronic whiplash and related symptoms a result of a specific injury. In opposition is the hypothesis that chronic whiplash is a functional somatic syndrome, and related symptoms a result of society-induced expectations and amplification of symptoms. According to both hypotheses, patients reporting chronic whiplash are expected to have more neck pain, headache and symptoms of anxiety and depression than the general population. Increased prevalence of somatic symptoms beyond those directly related to a whiplash neck injury is less investigated. The aim of this study was to test an implication derived from the functional hypothesis: Is the prevalence of somatic symptoms as seen in somatization disorder, beyond symptoms related to a whiplash neck injury, increased in individuals self-reporting chronic whiplash? We further aimed to explore recall bias by comparing the symptom profile displayed by individuals self-reporting chronic whiplash to that among those self-reporting a non-functional injury: fractures of the hand or wrist. We explored symptom load, etiologic origin could not be investigated in this study.MethodsData from the Norwegian population-based “Hordaland Health Study” (HUSK, 1997–99); N = 13,986 was employed. Chronic whiplash was self-reported by 403 individuals and fractures by 1,746. Somatization tendency was measured using a list of 17 somatic symptoms arising from different body parts and organ systems, derived from the research criteria for somatization disorder (ICD-10, F45).ResultsChronic whiplash was associated with an increased level of all 17 somatic symptoms investigated (p<0.05). The association was moderately strong (group difference of 0.60 standard deviation), only partly accounted for by confounding. For self-reported fractures symptoms were only slightly elevated. Recent whiplash was more commonly reported than whiplash-injury a long time ago, and the association of interest weakly increased with time since whiplash (r = 0.016, p = 0.032).ConclusionsThe increased prevalence of somatic symptoms beyond symptoms expected according to the organic injury model for chronic whiplash, challenges the standard injury model for whiplash, and is indicative evidence of chronic whiplash being a functional somatic syndrome.

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“…The exact risk of such non-recovery is not known, and mechanisms responsible for long-lasting symptoms are incompletely understood since objective clinical or imaging findings, specific for the injury, are rare. [2][3][4][5][6] As visual disturbances and dizziness are frequent complaints in whiplash-associated disorders, [7][8][9][10][11] vestibular and oculomotor testing has been proposed as helpful diagnostic tools in this syndrome. 12 Abnormal oculomotor findings are traditionally considered an indication of pathological conditions in the central nervous system or related to the inner ear, 13 but has been observed to be affected in cervical disorders as well.…”

Section: Introductionmentioning

confidence: 99%