Vestibular Injuries, WAD 2 or WAD 3?

Whiplash Associated Disorders - WAD

WAD 3 = Reports of Neck Pain and Neurological Signs.

Neurological Signs include Sensory Deficits.

A sensory deficit refers to a condition where a Person's Senses do NOT functional properly, and can include reduced ability to feel touch, pain, temperature, position or recognize objects. It can also mean a lack of precision and / or control of movements.

What does the research say?

Other authors found that about 50% of whiplash injury patients show objective abnormalities on vestibular testing, such as reduced caloric responses, positional nystagmus and, occasionally, increased “hyperactive” vestibular responses (Fischer et al., 1995; Healy, 1982; Kelders et al., 2005; Oosterveld et al., 1991).

What is the pathophysiology?

Proposed mechanisms of cervicogenic dizziness include overstimulation of cervical sympathetic nerves (Ellis et al., 2015; Hinoki,1985), aberrant afferent input from positional proprioceptors in the cervical spine, and compromised vertebral artery blood flow (Sandstrom, 1962).

Vibration of neck muscles in normal subjects can lead to illusions of motion (Karnath et al., 1994). The cervico-ocular reflex may be enhanced in patients with whiplash injury (Kelders et al., 2005).

Final Answer:

If a patient has positive Vestibular Testing, including all vestibular reflexes, then a WAD 3 diagnosis is most appropriate.