Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury.

OBJECTIVE To investigate cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury. DESIGN A 2-year review of consecutive patients admitted to the emergency unit after whiplash injury. SETTING An otorhinolaryngology department. PATIENTS AND SUBJECTS 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. MAIN OUTCOME MEASURES 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. RESULTS 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. CONCLUSION 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.

[1]  J Bergenius,et al.  Computerized analysis of voluntary eye movements. A clinical method for evaluation of smooth pursuit and saccades in oto-neurological diagnosis. , 1984, Acta oto-laryngologica.

[2]  I. Pyykkö,et al.  Rapid eye movements reflecting neurological disorders. , 1981, Clinical otolaryngology and allied sciences.

[3]  H Heikkilä,et al.  Cervicocephalic kinesthetic sensibility in patients with whiplash injury. , 1996, Scandinavian journal of rehabilitation medicine.

[4]  R. Evans.  Some observations on whiplash injuries. , 1992, Neurologic clinics.

[5]  B. Wyke.  CONFERENCE ON THE AGEING BRAIN CERVICAL ARTICULAR CONTRIBUTIONS TO POSTURE AND GAIT: THEIR RELATION TO SENILE DISEQUILIBRIUM , 1979 .

[6]  U. Moritz,et al.  Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. , 1996, Archives of physical medicine and rehabilitation.

[7]  M. B. Dutia,et al.  The muscles and joints of the neck: Their specialisation and role in head movement , 1991, Progress in Neurobiology.

[8]  M. Igarashi,et al.  Role of neck proprioceptors for the maintenance of dynamic bodily equilbrium in the squirrel monkey. , 1969, The Laryngoscope.

[9]  I. Pyykkö,et al.  Eye Movements in Cerebellar and Combined Cerebellobrainstem Diseases , 1983, The Annals of otology, rhinology, and laryngology.

[10]  H Johansson,et al.  Pathophysiological mechanisms involved in genesis and spread of muscular tension in occupational muscle pain and in chronic musculoskeletal pain syndromes: a hypothesis. , 1991, Medical hypotheses.

[11]  C. Hildingsson,et al.  Oculomotor problems after cervical spine injury. , 1989, Acta orthopaedica Scandinavica.

[12]  D. Hubbard,et al.  Myofascial trigger points show spontaneous needle EMG activity. , 1993, Spine.

[13]  U Rosenhall,et al.  Eye motility dysfunction in chronic primary fibromyalgia with dysesthesia. , 1987, Scandinavian journal of rehabilitation medicine.

[14]  R. McLain,et al.  Mechanoreceptor endings in human cervical facet joints. , 1994, Spine.

[15]  T. R. Garrett,et al.  Reliability of measurements of cervical spine range of motion--comparison of three methods. , 1991, Physical therapy.

[16]  D. Benson,et al.  Cerebral symptoms after whiplash injury of the neck: a prospective clinical and neuropsychological study of whiplash injury. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[17]  I. Macnab.  The "whiplash syndrome". , 1971, The Orthopedic clinics of North America.

[18]  F. Richmond,et al.  Anatomical organization and sensory receptor content of soft tissues surrounding upper cervical vertebrae in the cat. , 1982, Journal of neurophysiology.

[19]  W. Oosterveld,et al.  Electronystagmographic findings following cervical whiplash injuries. , 1991, Acta oto-laryngologica.

[20]  N. Bogduk,et al.  The Prevalence of Chronic Cervical Zygapophysial Joint Pain After Whiplash , 1995, Spine.

[21]  T. Yagi,et al.  Cervico-vestibular interaction in eye movements. , 1986, Auris, nasus, larynx.

[22]  M Hinoki,et al.  Vertigo due to whiplash injury: a neurotological approach. , 1985, Acta oto-laryngologica. Supplementum.

[23]  C. André-deshays,et al.  Cervicocephalic kinesthetic sensibility in patients with cervical pain. , 1991, Archives of physical medicine and rehabilitation.

[24]  I. Watt,et al.  The prognosis of neck injuries resulting from rear-end vehicle collisions. , 1983, The Journal of bone and joint surgery. British volume.

[25]  W Freedman,et al.  Cervico-ocular reflex in the normal adult. , 1980, Acta oto-laryngologica.

[26]  Rolf Johansson,et al.  Effects of restrained cervical mobility on voluntary eye movements and postural control. , 1991, Acta oto-laryngologica.

[27]  V Honrubia,et al.  Clinical Neurophysiology of the Vestibular System , 1980, Neurology.

[28]  Anthony Sances,et al.  Mechanisms of Head and Spine Trauma , 1986 .

[29]  F. Richmond,et al.  Muscle spindle complexes in muscles around upper cervical vertebrae in the cat. , 1982, Journal of neurophysiology.