- This grossly under diagnosed condition can occur as a result of
direct head injury or as a result of non-head impact neck
injuries, such as whiplash. Many doctors are unaware of the
objective neuro-diagnostic testing available to quantify MTBI.
- Advances in MRI Spectroscopy (SPECT) as well as Video
Electronystagmography (vENG) have increased the probability of
correctly diagnosing this condition.
- According to the American Academy of Neurology Practice
Parameter, the use of vENG has significant forensic value in the
diagnosis of "subtle brain injury." "In our
experience, from a forensic standpoint in non-coma brain injury
cases, this {vENG} is perhaps the single most useful test."
- Below are cited listings that support the use of vENG to
objectively diagnose MTBI as a result of non-head impact neck
injuries.
1. Acute flexion-extension injury of the neck.
Electronystagmographic study of 309 patients. Toglia JU.
2. Nonimpact brain injury: neuropsychological and behavioral
correlates with consideration of physiological findings.
Henry GK, Gross HS, Herndon CA, Furst CJ.
Appl Neuropsychol 2001;8(2):117-9; discussion 120
3. Cerebral disturbances following isolated whiplash injury
Kramer G, Hopf HC. Aktuelle Traumatol 1981 Aug;11(4):114-9
4. Electronystagmographic findings following cervical whiplash
injuries.
Oosterveld WJ, Kortschot HW, Kingma GG, de Jong HA, Saatci MR. Acta
Otolaryngol 1991;111(2):201-5
5. Whiplash Injury and Brain Damage" Drs. Ayub Ommaya, Fred Faas,
and Philip Yarnell, Journal of the American Medical Association, vol
204, No. 4 April 22, 1968
6. Journal of Head Trauma Rehabilitation Vol. 7:2 pp 103 "Mild
Traumatic Brain injury; Medical Assessment and Intervention"
Horn & Zasler, 1992
7. Dizziness from whiplash and head injury: differences between
whiplash and head injury.
Mallinson AI, Longridge NS.
8. PET with 18fluorodeoxyglucose and hexamethylpropylene amine oxime
SPECT in late whiplash syndrome.
Bicik I, Radanov BP, Schafer N, Dvorak J, Blum B, Weber B, Burger C,
von Schulthess GK, Buck A.
9. Post-traumatic vertigo in children: a diagnostic approach.
Eviatar L, Bergtraum M, Randel RM.
10. E.N.G. and the cervical syndrome neck torsion nystagmus.
Calseyde P, Ampe W, Depondt M.
11. [Optokinetic nystagmus and visual-vestibular interaction in
subjects with "whiplash injuries"
Salami A, Medicina MC, Dellepiane M, Mora R, Guglielmetti G.
12. Electronystagmographic evaluation of the vestibulo-ocular reflex
in children after brain concussion
Kazmierczak H, Polak M, Mackiewicz M.
13. [Infrared videonystagmography in vestibular diagnosis
Frisina A, Piazza F, Quaranta N.
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