You are on page 1of 18

Bad Kissingen

March 23-26,
2000
Docteur Raymond BONIVER
O.R.L.

Collaborateur et Maître de
Conférences à l’Université de
LIEGE
NEUROOTOLOGICAL
ASPECTS OF MEDICAL
EXPERTISE IN WHIPLASH
ASSOCIATED DISORDERS
INTRODUCTION
The legal redress for bodily injury goes
back to the very ancient concept of « Eye
for an eye - tooth for a tooth ». It is really
a kind of revenge fee for body lesions.
The financial compensation is the
civilised way to restore justice.
The need for a referee to avoid excess
compensation has quickly appeared.
This referee is the expert. He has to be
neutral and must detail the extent of the
lesions.
When it comes to evaluating bodily
injury, not only are the same terms
concerning invalidity, incapacity, etc.,
not used throughout the various
countries, but also the same terms - for
example, invalidity, have a different
sense from one country to the other. The
laws and their interpretations are also
different.
NEUROPHYSIOLOGY
GUIDE FOR
OTONEUROLOGICAL
APPROACH
Equilibrium Tests
1. Oculomotricity study
• Saccadic tests
• Pursuit tests
• Optokinetic tests
2. Vestibulo-ocular reflex study
• Spontaneous nystagmus:
• Head shaking nystagmus (Vidéo 1)
• Position and positioning nystagmus
• Rotatory tests
• Caloric tests
3. Posture tests
4. Gait tests
5. Various: . Vegetative disturbance analysis
. Cortico-equilibrium tests
Audiological Tests
These include:
1. Tonal audiometry
2. Supra-threshold audiometry
3. Speech audiometry
4. Tests for malignering
5. Evoked potentials
• BERA
• Middle latency
• Cortical audiometry
6. Tympanogram and stapedius reflex
7. Acoustic otoemission
Other Cranial Nerve Examinations

The following tests should be performed:


1. Gustometry
2. Olfactometry
3. Facial nerve testing
CONCLUSION
As we have written in the report of the first
EUFOS (European United Federation of
Otorhinolaringological Societies) meeting,
there is a great discordance not only
between the members of the medical
profession but also between the laws and
rules concerning disbility throughout
Europe.
We hope that in the near future a European
disability scale will be clearly defined. The
proposal for a standard battery test will be
the first step in the right direction.