Can Dizziness be caused by Car Accidents?

Most family physicians have had the experience of patients complaining of persistent dizziness following car crashes, especially of the rear end type.

I was in the unfortunate position recently of being the recipient of a medical legal report from a local family physician who opined that the cause of the post- MVA dizziness in his patient could not be the MVA because of ” no known link between trauma and dizziness”. Such an opinion will put this physician in a very awkward position at trial because there is a wealth of literature in peer reviewed journals that establish a clear causal link between car accident and dizziness.

For the rest of us who bother to pick up a medical journal once in a while, there are at least three known mechanisms for post- traumatic vertigo related to car collisions.

( a ) an ENT issue, specifically a disturbance in the inner war ( b ) a STI issue, related to a disturbance in the sympathetic nervous system incidental to a cervical strain ( c ) one of a constellation of symptoms constituting a concussion/mild traumatic brain injury.

It is not uncommon that the patient ‘s complaint of dizziness is delayed, I.e. not immediately reported. At some point, the causal link breaks and the probability if a causal link between the accident and the dizziness becomes untenable. When is that point of no return ?

Neal Longridge is an ENT specialist and a UBC professor. He is widely acknowledged as the top ENT physician in B.C. and one of the leading ENT researchers in the world. He is asked his opinion in the majority of MVA dizziness cases that come before the Court.

Dr. Longridge’s approach to causation isn’t necessarily academic or scientific. On the other hand, it is simple and pragmatic. Most importantly, it has been universally accepted by the Courts. His cut off mark is six months. If the patient complains of dizziness within six months of the accident, he will opine that the dizziness is likely to be the result of the accident.

If the dizziness is not part and parcel of a head injury, the next possibility option to explore is the ENT connection. If an ENT causal link is rendered unlikely, then we are left with a diagnosis of sympathetic dysfunction as a diagnosis of exclusion.