Heikkilä H V, Wenngren B I
Department of Psychiatry, University Hospital of Northern Sweden, Umeå.
Arch Phys Med Rehabil. 1998 Sep;79(9):1089-94. doi: 10.1016/s0003-9993(98)90176-9.
To investigate cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury.
A 2-year review of consecutive patients admitted to the emergency unit after whiplash injury.
An otorhinolaryngology department.
Twenty-seven consecutive patients with diagnosed whiplash injury (14 men and 13 women, mean age, 33.8yrs [range, 18 to 66yrs]). The controls were healthy subjects without a history of whiplash injury.
Oculomotor function was tested at 2 months and at 2 years after whiplash injury. The ability to appreciate both movement and head position was studied. Active range of cervical motion was measured. Subjective intensity of neck pain and major medical symptoms were recorded.
Active head repositioning was significantly less precise in the whiplash subjects than in the control group. Failures in oculomotor functions were observed in 62% of subjects. Significant correlations occurred between smooth pursuit tests and active cervical range of motion. Correlations also were established between the oculomotor test and the kinesthetic sensibility test.
The results suggest that restricted cervical movements and changes in the quality of proprioceptive information from the cervical spine region affect voluntary eye movements. A flexion/extension injury to the neck may result in dysfunction of the proprioceptive system. Oculomotor dysfunction after neck trauma might be related to cervical afferent input disturbances.
探讨挥鞭样损伤患者的颈-头动觉敏感性、颈椎活动度及动眼功能。
对因挥鞭样损伤入住急诊科的连续患者进行为期2年的回顾性研究。
耳鼻咽喉科。
27例连续诊断为挥鞭样损伤的患者（14例男性，13例女性，平均年龄33.8岁[范围18至66岁]）。对照组为无挥鞭样损伤病史的健康受试者。
在挥鞭样损伤后2个月和2年时测试动眼功能。研究对运动和头部位置的感知能力。测量颈椎活动度。记录颈部疼痛的主观强度和主要医学症状。
与对照组相比，挥鞭样损伤患者主动头部复位的精确性明显降低。62%的受试者存在动眼功能障碍。平滑追踪测试与颈椎活动度之间存在显著相关性。动眼测试与动觉敏感性测试之间也建立了相关性。
结果表明，颈椎活动受限以及来自颈椎区域的本体感觉信息质量变化会影响自主眼球运动。颈部屈伸损伤可能导致本体感觉系统功能障碍。颈部创伤后的动眼功能障碍可能与颈传入输入干扰有关。
