Resultados de pruebas de control postural y función vestibular en 51 pacientes con antecedente de latigazo cervical y síntomas de vértigo e inestabilidad

Abstract

IntroductionThe medical legal implications of dizziness and imbalance among patients with whiplash-associated disorders (WAD) are important. In these cases, Computerized Dynamic Posturography (CDP) provides information to standard vestibular tests and patterns consistent with scarce collaboration or lack of sincerity on efforts have been described. ObjectivesThis work has aimed to assess the prevalence of altered balance and vestibular function tests in patients with whiplash injury, and especially the aphysiologic results. Material and methodsA retrospective review of patients with whiplash injury referred for assessment of dizziness and/or imbalance was carried out. Standard videonistagmophgraphy (VNG) assessment including CDP was performed in all patients. The Sensory Organization Test (SOT) summaries were scored as normal, aphysiologic, or vestibular using the scoring method published by Cevette et al. in 1995. ResultsThe study included 51 patients (24 men, 27 women) with mean age: 42.2 years. Mean evolution time was 3.8 m. Aphysiologic CDP 13 (25.5%); vestibular CDP 9 (17.6%); normal CDP 29 (56.9%). Normal VNG 29 (56.9%); altered VNG in 22 (43.1%): vestibular VNG (n=11); central VNG (n=6); cervical VNG (n=5). VNG was altered in 46.2% of patients with aphysiologic CDP. ConclusionsThe prevalence of aphysiologic results on CDP among whiplash injury patients is relatively high, however, this should not necessarily be consider to be related to malingering or exaggeration since objective signs of vestibular dysfunction are found in many cases. Thus, we recommend these tests should be done in whiplash injury patients complaining of dizziness and imbalance. Vestibular rehabilitation could be of interest in the recovery of these patients.