Hinoki M
Acta Otolaryngol Suppl. 1985;419:9-29.
A series of examinations were carried out to elucidate the characteristics of vertigo due to whiplash injury. In patients with whiplash injury, there are over-excitation of the cervical and/or the lumbar proprioceptors on one hand, and dysfunction of the central nervous system, such as the hypothalamus, the brain stem and the cerebellum, on the other hand. These two etiological factors induce disequilibrium by a trigger-and-target relationship in which the above proprioceptors act as a trigger and the central nervous system acts as a target. This postulate is applicable to the explanation of aural vertigo following whiplash injury. Autonomic reflexes in patients with whiplash injury can be explained not only as due to over-excitation of the cervical sympathetic nerves, but also to that of the cervical and lumbar proprioceptors. In other words, these reflexes are considered as being the proprio-autonomic reflexes. These reflexes are more evident in patients with cervical pain. Cerebellar symptoms can be manifested by over-excitation of the cervical and lumbar proprioceptors. These symptoms are more evident in patients with lumbar pain. The above differences in the autonomic reflexes and cerebellar symptoms of patients with cervical and/or lumbar pains can be explained on the basis of known fiber connections in the central nervous system. Hypertonicity of the cervical and lumbar erector muscles in patients with whiplash injury can be explained not only as due to over-excitation of gamma fibers, but also to that of sympathetic nerves in these muscles. This hypertonicity affects the central nervous system, causing disequilibrium following whiplash injury.
为阐明挥鞭样损伤所致眩晕的特征，进行了一系列检查。在挥鞭样损伤患者中，一方面存在颈段和/或腰段本体感受器的过度兴奋，另一方面存在中枢神经系统功能障碍，如下丘脑、脑干和小脑。这两个病因因素通过一种触发-靶点关系导致失衡，其中上述本体感受器作为触发因素，中枢神经系统作为靶点。这一假设适用于解释挥鞭样损伤后的耳性眩晕。挥鞭样损伤患者的自主反射不仅可解释为颈交感神经的过度兴奋，也可解释为颈段和腰段本体感受器的过度兴奋。换句话说，这些反射被认为是本体-自主反射。这些反射在颈部疼痛患者中更为明显。颈段和腰段本体感受器的过度兴奋可表现出小脑症状。这些症状在腰部疼痛患者中更为明显。颈段和/或腰段疼痛患者自主反射和小脑症状的上述差异可根据中枢神经系统中已知的纤维连接来解释。挥鞭样损伤患者颈段和腰段竖脊肌的张力亢进不仅可解释为γ纤维的过度兴奋，也可解释为这些肌肉中交感神经的过度兴奋。这种张力亢进影响中枢神经系统，导致挥鞭样损伤后失衡。
