Dipartimento Discipline Chirurgiche ed Oncologiche-UO Otorinolaringoiatria, Università degli Studi di Palermo, Italia.
Am J Otolaryngol. 2011 Sep-Oct;32(5):376-80. doi: 10.1016/j.amjoto.2010.07.009. Epub 2010 Sep 15.
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.
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.
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.
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.
本研究旨在评估挥鞭伤后良性阵发性位置性眩晕（BPPV）的真实发生率、诊断和治疗，并将这种类型的创伤后眩晕与创伤后其他类型的头晕区分开来。
这是一项回顾性研究，包括因挥鞭伤而转诊至我们中心的患者。通过包括床边和仪器检查在内的神经耳科检查对患者进行评估。在治疗前后提交了一份评估患者症状的眩晕障碍量表（Dizziness Handicap Inventory）并进行评估。将 BPPV 患者与颈源性眩晕患者分别进行评估，并与特发性 BPPV 的我们的数据进行比较。
评估了 18 例挥鞭伤后出现 BPPV 的患者。平均年龄为 38.2 岁。BPPV 是总挥鞭伤患者中 33.9%眩晕的原因。16 例为后半规管受累，2 例为外半规管受累。仪器神经耳科学评估未显示前庭脊髓反射或动态眼球运动有任何改变。治疗前症状持续时间从 3 天到 26 天不等。首次复位手法后，55.5%的患者症状缓解。所有接受复位手法治疗的患者的眩晕障碍量表评分均有所改善，但与特发性 BPPV 数据无差异。
通过外周前庭系统的简单床边检查可以揭示挥鞭伤后的 BPPV，并且可以在同一就诊时进行治疗。创伤后 BPPV 的诊断与特发性形式没有区别，但治疗可能需要更多的手法才能达到满意的效果。
