J Chin Med Assoc • December 2006 • Vol 69 • No 12
591
© 2006 Elsevier. All rights reserved.
Introduction
Whiplash injury involves hyperextension of the neck
followed by flexion, and typically results from an
automobile accident when a person has been hit from
behind. Although the majority of people recover
within weeks or months, about 12–40% will persist in
having complicated sequelae such as neck pain, stiff-
ness, painful paresthesia of the neck and upper limbs,
temporomandibular dysfunction, dizziness, tinnitus,
and headaches, which are hard to elucidate and treat.1
These symptoms are collectively called whiplash-
associated disorders (WADs). Among these symptoms,
dizziness may be most bothersome for the patient, and
it is also most difficult to treat. As there is no specific
medication for the treatment of dizziness, a special
method of rehabilitation, so-called vestibular rehabili-
tation, has recently gained widespread attention. The
concept of head, body and coordinated eye exercises
is applied for patients who suffer from motion intoler-
ance and imbalance problems.2 We report a patient with
whiplash injury who had all of the symptoms described
above. Satisfactory results were obtained after a com-
prehensive multidisciplinary rehabilitation program.
Case Report
A 23-year-old woman, who was generally healthy
before, with no major surgical history or systemic dis-
ease, had a traffic accident while she was riding a motor-
cycle. She was hit from behind by a car, and was thrown
into the air. Epistaxis with multiple lacerated wounds
over her right-side face, nose, and limbs were noted. No
initial loss of consciousness was experienced, but she felt
dizziness with painful numbness of bilateral upper limbs
immediately after the impact. Physical examination in the
emergency room revealed multiple lacerations over her
CASE REPORT
Vestibular Rehabilitation in a Patient with
Whiplash-associated Disorders
Kwo-Shieng Tuo1, Yuan-Yang Cheng2, Chung-Lan Kao2,3*
1Department of Physical Medicine and Rehabilitation, Kaohs