Claussen C F, Claussen E
Neurootological Research Center, Bad Kissingen, Germany.
Acta Otolaryngol Suppl. 1995;520 Pt 1:53-6. doi: 10.3109/00016489509125188.
Only in 1992 we had to deal with about 197,731 cases of whiplash injuries due to traffic accidents on the roads of Germany. About 80% recover within a few months. However, about 15%-20% develop the so-called late whiplash injury syndrome with many complaints of the cervico-encaphalic syndrome including headache, vertigo, instability, nausea, tinnitus, hearing loss etc. The orthopedic as well as the radiological findings are mostly unsatisfactory with respect to the neurosensorial complaints. Therefore problems of evidence arise in compensation claims calling for additional neurootological medical expertise. When analysing 124 expert examinations of our patients suffering from late whiplash injury syndrome we found that the average case had already seen 3.83 medical experts elsewhere including 18 different medical specialities. At the most, we observed 17 expertise visits/case prior to the patients visit to us. In the present study we compared the results from 42 neurootological expertise cases with 206 cases of late whiplash injury syndrome, who only came for treatment purposes to our neurootological practice. Al our patients underwent a systematic history (NOASC I) and a functional neurootological, audiometric and equilibriometric examination. Thus we tried to assess the location and nature of the functional degeneration underlying the posttraumatic residual vertigo symptoms, etc. The objective and quantitative equilibrium investigations included several ENGs and an analysis of the cranio-corpo-gram, thus obtaining a record of the gait and standing patterns by means of a radar-like image of the marker tracings from the head and the shoulders during stepping and standing, as well as during bending, extending and turning the neck (computer CCG). Thus individual patterns of functional lesions in the neurootological pathways can simultaneously? objectively and quantatively be worked out for both the groups confirming the subjective complaints.
仅在1992年，德国道路上因交通事故导致的挥鞭样损伤病例就达约197,731例。约80%的患者在几个月内康复。然而，约15% - 20%的患者会发展为所谓的迟发性挥鞭样损伤综合征，伴有许多颈脑综合征的症状，包括头痛、眩晕、身体不稳、恶心、耳鸣、听力丧失等。对于这些神经感觉方面的症状，骨科以及放射学检查结果大多不尽人意。因此，在赔偿要求中出现了证据问题，这就需要额外的耳神经学专业医学鉴定。在分析我们124例迟发性挥鞭样损伤综合征患者的专家鉴定时，我们发现平均每个病例在其他地方已经看过3.83名医学专家，涉及18个不同的医学专业。我们观察到，在患者来我们这里就诊之前，最多的病例曾接受过17次专家鉴定。在本研究中，我们将42例耳神经学专家鉴定病例的结果与206例迟发性挥鞭样损伤综合征病例的结果进行了比较，后者只是出于治疗目的前来我们的耳神经学诊所。我们所有的患者都接受了系统的病史询问（NOASC I）以及功能性耳神经学、听力测定和平衡功能检查。因此，我们试图评估创伤后残留眩晕症状等潜在功能退化的位置和性质。客观和定量的平衡功能检查包括多次眼震电图检查以及颅-体图分析，从而通过在行走、站立以及颈部弯曲、伸展和转动过程中头部和肩部标记轨迹的类似雷达图像记录步态和站立模式（计算机CCG）。这样，就可以同时针对两组患者客观、定量地确定耳神经学通路中功能损伤的个体模式，从而证实主观症状。
