Role of spinal inhibitory mechanisms in whiplash injuries.

Abstract:

:Whiplash injury, commonly encountered in road traffic accidents, is a major cause of morbidity. Its pathophysiology is not well understood, and diagnosis remains clinical. Imaging and electrophysiological methods have not provided objective diagnostic evidence. Availability of a sensitive and specific diagnostic method would be of high clinical interest. We studied 20 consecutive patients with chronic whiplash injury. Despite persistent symptoms, most had minimal neurological findings. Cutaneous silent period (CSP), a nociceptive spinal inhibitory electromyographic reflex, showed 90% sensitivity and 90% specificity for its diagnosis. In contrast, only two patients (10%) had abnormal transcranial magnetic stimulation findings, and another two (10%) showed abnormal electromyography. Magnetic resonance imaging (MRI) showed cervical cord abnormalities in only two of 20 (10%) patients. None of the patients had abnormal somatosensory evoked potential studies. Our findings suggest that neurological dysfunction of whiplash may occur at several possible spinal cord localities in the CSP functional pathway. The use of this simple, quick, and sensitive method is advocated in the diagnostic work up of whiplash injury.

journal_name

J Neurotrauma

journal_title

Journal of neurotrauma

authors

Lo YL,Tan YE,Fook-Chong S,Boolsambatra P,Yue WM,Chan LL,Tan SB

doi

10.1089/neu.2006.0222

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

1055-67

issue

6

eissn

0897-7151

issn

1557-9042

journal_volume

24

pub_type

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