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University of Michigan scientist Susan Shore examines the location of stimulating and recording electrodes used to track nerve cell activity in the brain’s auditory center.
Touch-sensing nerve cells step up their activity in the brain after hearing cells are damaged, a study by U-M Kresge Hearing Research Institute scientists shows. The research findings were made in animals, but they suggest that available treatments such as acupuncture, if used to target nerves in the head and neck, may provide relief for some people plagued by tinnitus, says Susan E. People with tinnitus sense ringing or other sounds in their ears or head when there is no outside source. Increasing numbers of baby boomers are also finding that when they can’t hear as well as they used to, tinnitus seems to move in. Tinnitus varies in individuals from a faint, high-pitched tone to whooshing ocean waves to annoying cricket-like chirping or screeching brakes. Some people, oddly enough, find that if they clench the jaw or press on the face or neck, they can temporarily stop tinnitus, or in some cases bring it on. In normal hearing, the dorsal cochlear nucleus is the first stop in the brain for sound signals arriving from the ear via the auditory nerve.
The somatosensory system is a nerve network in the body that provides information to the brain about touch, vibration, skin temperature and pain. But when people experience hearing loss or some other event, such as having a cavity filled or a tooth implanted, these neurons from the face and head can respond like overly helpful relatives in a family crisis. U-M researcher Susan Shore and U-M graduate student Seth Koehler discuss electrophysiological data being collected during an experiment.
Shore’s research team knew from earlier research that some neurons in the cochlear nucleus become hyperactive after hearing damage, and this hyperactivity has been linked to tinnitus in animals.
Many people with temporomandibular joint syndrome (TMJ), a condition that causes frequent pain in the jaw, experience tinnitus. In addition to Shore and Koehler, Mark Oldakowski, a U-M research associate at the time of the study, Sana Syed, then a U-M student in the Undergraduate Research Opportunity Program and Larry F. Funding for this research came from the Tinnitus Research Consortium, the Tinnitus Research Initiative and the National Institutes of Health. Home » Earworms » What is the difference between musical hallucinations and tinnitus? Before I left for Switzerland at the start of this month I printed off a few articles that I had hoped to read for background research, and also to provide you, dear reader, with some of the latest findings in music psychology. This new paper tackles the question of whether musical hallucinations and tinnitus are similar phenomena.
In both cases people can often not realize at first that these sounds are not ‘real’ – they may go searching for the source of the sound (a hidden radio or a buzzing piece of electrical hardware) eventually to realize that the sound is being generated internally rather than externally. The new paper I am reading hypothesised that MH and tinnitus might share a common source in the brain that differs only in its complexity, with tinnitus producing simple sound and MH producing complex music.
The model: The model the authors chose was ‘Thalamocortical dysrhythmia’ (TCD), a suitably complex term (go on, say it three times fast, I dare you!). The difference that turns tinnitus into MH might be found in brain areas like Broca’s , regions of the brain that handles both language and music stimuli.
The test: The new study used EEG to compare resting state brain activity between healthy controls, and people with either tinnitus or MH. The results: People with MH or tinnitus both showed increased gamma-theta activity within their auditory cortex. Interestingly both groups also showed suppressed beta band activity in their visual cortices. There was also increased beta activity in areas such as the dorsal anterior cingulate cortex and anterior insula during both tinnitus and MH.
Conclusions: The TCD model may prove to be a suitable explanation for both musical hallucinations and tinnitus, since both were seen in the new study to feature the relevant abnormal patterns of neural activity. Complex phantoms (MH) in addition are associated with additional patterns of abnormal neural activity in various bands across areas of the brain that are associated with memory and musical imagery, but also language processing. Sven Vanneste, Jae-Jin Song, Dirk De Ridder (2013) Tinnitus and musical hallucinosis: The same but more.
After a weekend of digging weak Morse signals out of the noise, when I finally take off the headphones I can hear phantom Morse code in things like computer fans, building ventilators and even in the wind noise on the windows. About three years ago I was hearing music from an external source that didnt exist, (not like hearing music in your mind like when a song gets stuck in your head).
Candace Hartley 19 November, 2013 at 12:26 am My tinnitus is like a million little tsetse flies in my head and I sometimes cry myself to sleep wishing to be free of them. Tony Gordon 29 November, 2013 at 1:15 pm I have reviewed the medical literature and convinced myself at least that musical hallucinations like tinnitus originate in the inner ear.
Victoria Bowden 26 April, 2014 at 6:33 pm About a year ago I startet having trouble getting off to sleep because my neighbour was playing music. I was working on the computer and committed to my traveling partner how much I was enjoying the radio station she was playing.
AS 17 December, 2014 at 5:44 am I can’t say how glad I am to find your blog and article!! Beginning of this year though I started getting song choruses playing on repeat and the tinnitus has become quiet noticeable again. Tony Gordon 23 July, 2015 at 3:34 pm After extensive reviews of the literature, I have concluded that musical hallucinations only arise from an oversensitive inner ear, and are nothing to do with the brain. Tom 5 March, 2016 at 4:52 pm I appreciate the science-based approach to investigating this phenomenon, but I want to offer my experience and a different possible explanation. In the late summer of 2010, I began to hear musical patterns in the white noise of the air conditioning vents.
Science is missing something about who & what we really are by not closely examining the experiences themselves and looking at things only in a purely rationalistic, materialistic fashion. We summarize our long-tean clinical experiences with an inner-ear drug delivery system (DDS) for control of tinnitus. The dangers of perforating the eardrum and of inciting the discomfort of vertigo as a result of the transtympanic injection of dexamethasone are minimal. The management of tinnitus has been the topic of many articles and special meetings of scientific societies. Our clinical trials of an inner-ear drug delivery system (DDS) for control of inner-ear problems began in 1974 [1].
Consequently, in 1981, we began to use liquid dexamethasone for STT to the inner ear, to control various kinds of inner-ear diseases and symptoms [3]. The procedure we employed for our therapeutic modality has already been reported elsewhere [4-7].
To evaluate the control effects of this therapy on tinnitus, a 10-division subjective evaluation system was used. Short-term effects on tinnitus were evaluated 2 weeks after the fourth intratympanic dexamethasone perfusion.
The short-term overall effects on tinnitus of dexamethasone perfusion into the tympanic cavity were positive in 75% of patients.
Figure 2 depicts the effectiveness of drug management of tinnitus in the presence of various underlying diseases. The effects of our DDS trials on tinnitus control and average hearing levels ranged between 64% and 72%.
Evaluation of the effects on various pitches of tinnitus indicates that high-tone tinnitus was less improved than was low-pitched tinnitus. The long-term effects on tinnitus of dexamethasone perfusion into the tympanic cavity were evaluated at approximately 6 months after the last injection. In this intratympanic dexamethasone perfusion technique, it is assumed that the medicine that was introduced directly into the tympanic cavity acts on the plexus tympanicus, is absorbed through the round window, and acts on the inner ear [8-13] . The short-term side effects of the inner-ear DDS that we describe include pain at the time of tympanic puncture and temporary vertigo immediately after the injection. Tinnitus is a neurological condition, so it’s no surprise that scientists from the University of Texas at Dallas’ School of Behavioral and Brain Sciences are testing the effects of vagus nerve stimulation (VNS) and auditory tones on people experiencing severe tinnitus- persistent ear ringing, buzzing sounds, headaches, vertigo, and ear pressure. Already approved by the FDA for treating depression and epilepsy, scientists are trying to determine if VNS-tone therapy can also be used safely for sufferers of chronic tinnitus. Vagus nerve stimulation works by emitting mild electrical currents through the vagus nerve, eliciting a response from the brain. All study participants had suffered from constant tinnitus for at least one year, and have not benefited from previous attempts to reduce tinnitus. Half of all tinnitus sufferers noted significant improvement following the 20-day therapy, and three in particular reported a 44% reduction in tinnitus-related stress or handicap.
The results are promising; even more than two months after the trial, four out of ten tinnitus patients continued to enjoy a reduction in tinnitus symptoms, say scientists. If you found this article helpful, then please share with your friends, family, and coworkers by email, Facebook, or Google+.
350 patients with hearing loss and tinnitus due to advanced age were treated with the key ingredients of TinniFree, and the success rate for improved hearing and tinnitus was 82%. This formula is the most comprehensive hearing support formula, with targeted ingredients shown to be effective for noise-free hearing support. From 2001 to 2006, we performed a retrospective study of patients suffering from chronic unilateral or bilateral tinnitus that was previously ineffectively treated by oral drugs [betahistine (Betaserc), extract of Ginkgo biloba (EGb 761), tanakan (Tebokan), and cinnarizinedimenhydrinate (Arlevert), singly or in combination]. Tinnitus is the phantom perception of sound in the absence of overt acoustic stimulation [1]. We randomly divided the patients into seven distinct treatment groups and administered treatment as specified.

The pentoxifylline (PTX) group received daily for 10 days an intravenous infusion of 100 mg pentoxifylline and 250 ml physiological saline. In addition, there were groups treated by pentoxifylline plus physiotherapy (PTX-RHB) and pentoxifylline plus physiotherapy and soft laser (PTX-RHB-soft laser), which consisted of a total of 9 persons.
The visual analog scale from 0 (no tinnitus) to 10 (unbearable tinnitus) was used for daily evaluation. We used an enhanced method for construction of a binary classification tree-a regression method computed by condition of maximized homogeneity of treatment methods used [by Agapurin (Trental), Cavinton, lidocaine] in terminal leaves. In computing progress, we found that treatment PTX and age metric were ambiguous and so we dropped them, with no effect on our results. Combination of Cavinton and physiotherapy was the most effective treatment seen in all the groups (see Fig. The groups treated by pentoxifylline plus physiotherapy (PTX-RHB) and pentoxifylline plus physiotherapy and soft laser (PTX-RHB-soft laser) consisted of a total of 9 persons, and the outcomes were considered to be statistically insignificant. Because tinnitus is a subjective symptom, we used the subjective scale-the visual analog scale-as the only parameter. To help customers to choose the tinnitus relaxer that best suits them we have recorded the sounds of the ones that we sell.
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Nerves that sense touch in your face and neck may be behind the racket in your brain, University of Michigan researchers say. Her work sheds light on the link between hearing loss and the widespread problem of tinnitus.
The condition commonly occurs with hearing loss, but also after head or neck trauma such as whiplash or dental work.
To understand tinnitus and its strange link to touch sensations, Shore and her research team have conducted a series of studies in guinea pigs, measuring nerve activity in a part of the brain called the dorsal cochlear nucleus that processes auditory and other signals. The somatosensory system is coming in, but may overcompensate and help cause tinnitis,” she says.
The part of the system that provides sensations from the face and head, called the trigeminal system, brings signals to the cochlear nucleus that help us hear and speak. Hughes, a professor at the Southern Illinois University School of Medicine, are co-authors of the paper. It has been a long few weeks here in Luzern as I have been balancing immigration admin, with the freedom that comes with being able to write up articles that have been sitting on my desk for months. This is of interest to me as these two kinds of ‘auditory phantom’ may also be on a continuum with earworms, tunes that get stuck in our head (a keen research interest for me).
Tinnitus is when a person hears a simple tone or buzzing noise that is not coming from the environment. MH are complex false sound perceptions meaning that a fully conscious person might report hearing whole songs or other musical arrangements, all of which have no external source. Both MH and tinnitus represent the perception of a sound stimulus in the absence of any physical stimulation from the environment – people are hearing things that are not ‘there’. Because people can eventually recognize the internal source of the sound MH and tinnitus are not, by themselves, a form of “psychosis”, which is defined as a loss of contact with reality. TCD is a theory that suggests the neurons in the thalamus can start to behave in an odd way, either diminishing their excitation or increasing their inhibition. According to the new paper, tinnitus may be caused by abnormal, spontaneous and constant gamma band activity as a consequence of a particular pattern of deafferentation in the thalamic nuclei. Perhaps a low level “edge effect” combined with higher brain centre abnormal activity turn simple tinnitus into MH? The hypothesis was that both simple (tinnitus) and complex (MH) auditory phantoms will share a common neural signature of increased gamma-theta activity in combination with decreased alpha activity, as in TCD. The two clinical groups had both had their symptoms for at least a year and had comparable hearing loss (not severe). This finding alone suggests that TCD might underlie both simple (tinnitus) and complex (MH) auditory phantoms. This activity might be related to the brain ‘filling in’ missing auditory information and brining the phantom auditory percepts to awareness.
People with MH showed more alpha activity, which we can explain as the increased memory load of dealing with complex percept as opposed to a simple buzz or ring of tinnitus. It happened out of the blue while I was fully functioning speaking even, when doing a university presentation, on the subway etc. At first it was complete songs with choir like voices and big band music with all the movements. I SUFFER WITH FIBROMYALGA WHICH AMONGST MANY OTHER SYMPTOMS MEANS MY SENSES ARE HEIGHTENED.
This is the first time I have read a good description and a possible explanation for this condition I’ve developed over the last year. The inner-ear DDS consist of transtympanic perfusion of 2 or 4 mg dexamethasone to the round window via the middle ear. We believe that the transtympanic infusion technique is an effective DDS for control of inner-ear diseases and symptoms. In this article, we describe some 15 years of clinical experience with steroid targeting therapy (STT) to the inner ear for control of tinnitus. The inner-ear DDS that we employ consists of transtympanic perfusion of medicine to the round window via the middle ear.
The intratympanic injection was performed in our outpatient clinic with the patient in the sitting or the supine position. The subjects were 3,978 ears of 3,041 patients who received intratympanic dexamethasone perfusion for the management of vertigo, tinnitus, and the like.
Patients then were investigated 6 months after the injection, at which time the long-term effects on tinnitus were evaluated. Effects on tinnitus of intratympanic dexamethasone perfusion in the presence of various underlying diseases. Effects on tinnitus of intratympanic dexamethasone perfusion in relation to disease duration.
The same 10-division subjective evaluation was used as was applied for the short-term evaluation.
The mechanism of action of this therapeutic modality is multifactorial, including sedative effects, a metabolic improving effect, and an edema-relieving effect, which may eliminate abnormal excitation of auditory hair cells, which are believed to cause tinnitus. Itoh A, Sakata E: Treatment of vestibular disorderIntratympanic dexamethasone injection and inner ear anesthesia with lidocaine. Ristow W: Zur Behandlung der Meniereschen Krankheit mittels tympanaler Labyrinthanaesthesie.
Constant ear ringing, dizziness, headaches, and head pressure make it difficult to concentrate or function normally. Feel free to join the discussion by leaving comments, and stay updated by subscribing to the RSS feed. The TinniFree formula is based on clinical journal reports cited by leading tinnitus research organizations. It is well known that chronic tinnitus is difficult to treat, though lots of modalities are used for treatment. Because the studies available on MEDLINE report different outcomes [8,10-12,14], we tried to evaluate the most widely used therapeutic approaches in our hospital: drop infusion of lidocaine, vinpocetine, or pentoxifylline and combination of these drugs with low-level laser therapy and physiotherapy. Before and after treatment, each patient underwent basic ear, nose, and throat examination, including otomicroscopy, basic vestibular examination, pure-tone audiometry, and tinnitometry. Those in the Cavinton group received daily for 10 days an intravenous infusion of 20 mg Cavinton plus 250 ml physiological saline, and oral Cavinton 2 Χ 10 mg (0-2-2). As the outcomes were considered to be statistically insignificant, the findings from these groups are not evaluated further. Patients' symptoms were evaluated as improved if their tinnitus was perceived to be better by two or more points on this scale. We had four metrics-age, duration of tinnitus, gender, and audiometry-each of which could be used to divide cases into branches.
The boundary in the age metric was found at 62 years; in tinnitus duration, the value was 15 months. Effectiveness of therapy in each of seven treatment groups, determined by using a visual analog scale. Only 1 patient of those 9 experienced a decrease in tinnitus intensity; the rest saw no change.
The most effective treatment according to the age, tinnitus duration, and audiometric findings. Many patients with positive tinnitus changes (according to the visual analog scale) experienced changes in quality of life, so the quality-of-life questionnaire should be used in further studies.
They used a 16-electrode array to measure signals from the trigeminal nerve and multisensory neurons in the dorsal cochlear nucleus. Musical hallucinations are more common in older adults, especially those who are suffering from a degree of hearing loss. This haywire activity at the neural level, known as ‘deafferentation’, can trigger both positive and negative symptoms in neurological conditions.
This can be combined with an increase in theta activity, and perhaps also a decrease in alpha activity. People with MH also showed increased resting state activity in right inferior frontal regions, areas associated with retrieval of familiar musical imagery from memory, and areas associated with language and music processing. Musical seizures are indeed very rare and can be completely benign, but in some cases they can indicate an underlying neurological problem.
I have not seen a doctor yet because everything I’ve read indicates there is little that can be done.

Now it has settled on five or so songs but is now only playing the ending or a chorus not the full song. There is my head was the bird noise and a song was playing our Amazing Grace with a choir singing . Larry’s comment is especially relatable for me, as I have song ends or choruses play on repeat. I have found very little information on this condition until now, and what you’ve said makes a lot of sense to me. Therapeutic results of steroid targeting therapy to the inner ear were evaluated in 3,978 ears of 3,041 patients.
At the beginning of our clinical trials of this system, we used 4% lidocaine hydrochloride to alleviate distressing inner-ear symptoms of tinnitus, recruitment, fullness or stiffness in the ear, and vertigo. Dexamethasone, 2 or 4 mg, was introduced into the middle-ear cavity through a fine needle, just as is done in tympanic puncture. The severity or annoyance of tinnitus before the injection was regarded as being at level 10, and the level after the injection of drug was expressed as a score from 1 to 10.
In contrast, the effec-tiveness of our therapeutic regimen on tinnitus accompanied by streptomycin deafness was 48% and, in the presence of head injury, this figure dropped to 42%. Overall positive effects on tinnitus were seen in 75% of cases immediately after intratympanic dexamethasone perfusion and in 68% after 6 months.
In Meniere's disease, steroid injection to the middle ear might improve endolymphatic hydrops. Now, scientists believe they can relieve tinnitus symptoms through a nerve stimulation treatment already approved for epilepsy. Reproduction in whole or in part in any form or medium without express written permission is prohibited. Treatments consisted of application of intravenous pentoxifylline, lidocaine, or vinpocetine (Cavinton) and combination of these agents with physiotherapy and soft laser. Guidelines for inclusion of each patient into an appropriate treatment group are still missing. All patients had previously been treated ineffectively by various oral drugs [betahistine (Betaserc), extract of Ginkgo biloba [EGb-761], tanakan [Tebokan], cinnarizine-dimenhydrinate (Arlevert)], or their combination] for at least 6 months. To those in the lidocaine group, we gave a daily intravenous infusion of 40 mg lidocaine hydrochloride plus 250 ml physiological saline for 10 days. According to audiometry, we had three subgroups: bilateral normal hearing, unilateral normal hearing, and bilateral hearing loss.
The output classification tree divided the patients into groups according to the metrics (Fig.
As we compared the groups of either Cavinton or lidocaine infusion alone with groups who received one of these agents combined with physiotherapy with or without soft laser, the effectiveness of combination therapy was assessed as being better. The combinations of lidocaine with RHB and with RHB plus soft laser were assessed by the classification tree as being effective for patients younger than 62 years who had tinnitus lasting for more than 15 months (Fig. We hope that our outcomes will be helpful for patients suffering from chronic tinnitus, and we encourage our colleagues to undertake further research. Neuroprotective drug therapy: A medical and pharmacological treatment for tinnitus control. Glutamate antagonists, steroids and antioxidants as therapeutic options for hearing loss and tinnitus and the use of inner ear drug delivery system. Vinpocetine prevents 4-aminopyridine- induced changes in the EEG, the auditory brainstem responses and hearing. The inhibitory effect of intravenous lidocaine infusion on tinnitus after translabyrinthine removal of vestibular schwannoma: A double-blind, placebo-controlled, crossover study.
Transmeatal cochlear laser (TCL) treatment of cochlear dysfunction: A feasibility study for chronic tinnitus.
When they compared results in the two groups, they found clear differences in trigeminal nerve activity. I have also been enjoying the planning and teaching of my new Music Psychology course, here at the Hochschule Luzern – Musik. Many of us will have experienced temporary tinnitus, perhaps after visiting a concert or nightclub, or exposure to other loud and prolonged sounds. MH can also arise from brain lesions at any point in the auditory pathway, from the lower centres (e.g. It was very frightening I had no other physical symptoms and I couldnt find any info on the internet relating to my hearing music that wasnt there. I am very happy that you found good help and once again, thank you for bringing your story to this forum. Eventually, I mentioned to my neighbour who looked confused, but said it couldnt be her as she doesnt play any music at all. Then also there was another musical selection of two accordions playing in harmony the selection was notes that were not exact but closely resembling our national anthem. I also find that if I switch music off at the wrong point my head finishes off for me so it has reached a resolution of some sort, which has been great at times for developing arrangements!
I got tinnitus about 14 years ago, I can remember the day I noticed it, I had just had bronchitis and finished a course of antibiotics. I am going in for an EEG when my doctor is back in January and I will tell her about your article.
Tinnitus improved in 75% of these patients immediately after treatment and in 68% after 6 months. Although the injection of 4% lidocaine hydrochloride is very effective for controlling inner-ear problems, patients complained of vertigo for several hours after the injection of medicine [2].
Before the procedure, the patient was asked to try to hold his or her posture steady and to avoid swallowing during the injection and for approximately 15 minutes thereafter to prevent the escape of dexamethasone through the Eustachian tube. A level of 0-2 for the residual symptoms represented good effects, 3-6 represented fair effects, and 7-10 represented poor effects. The improvement of tinnitus with labyrinthine hydrops was good, but effectiveness for noise-or druginduced tinnitus was poor. It appears that, to some degree, tinnitus control via our therapeutic regimen remained constant.
Takahashi K, Ohtsu K: Pathology and treatment of cochlear tinnitus by blocking with 4% lidocaine and dexamethasone infusion. In our study, we evaluated some of the current treatment modalities to define the most effective for a certain group of patients. The Cavinton-plus-physiotherapy (Cavinton-RHB) group received a daily intravenous infusion of 20 mg Cavinton plus 250 ml physiological saline, and oral Cavinton 2 Χ 10 mg, combined with physiotherapy (soft techniques, including temporomandibular joint massage), the entire procedure lasting 20 minutes once daily for 10 days. We crossed all boundaries that are created as a midpoint between all recorded numerical data on all metrics and sought maximized homogeneity. 1) treated by lidocaine (contains lidocaine infusion, lidocaine-RHB, and lidocaine-RHB-soft laser groups) or by Cavinton (contains Cavinton, Cavinton-RHB, and Cavinton-RHB-soft laser groups).
Doctors said it was brought on by stress, that I should do yoga but I knew it was something different, something wasnt right. However, I’m not sure if the following is related, but I can now hear, at will, certain pieces of music. However, when tinnitus is continuous and loud, it can interfere with a person's quality of life and may be so annoying as to incite neurosis. The ma-jority of the patients could not be treated successfully by oral administration of vasodilators or mild sedatives. The aim of our study was to compare treatment modalities and define their effectiveness for tinnitus relief. For the Cavinton-RHB-soft laser group, we administered a daily intravenous infusion of 20 mg C Those in the lidocaine-RHB group were given a daily intravenous infusion of 40 mg lidocaine plus 250 ml physiological saline, combined with physiotherapy, for 10 days. When we finished dividing by all metrics (or when it was superfluous to continue with such division), we decided on classification of terminal leaf by the bayesian method. We did not find any additional effect of soft laser, but we expect that the effect of soft laser on biostimulation cannot be observed during 10 days of therapy. The improvement of tinnitus in the presence of labyrinthine hydrops was good, whereas the effects on noise-or drug-induced tinnitus were poor.
Some patients with an inner-ear problem experience such overwhelming tinnitus that they would "cut off their ear" or "poke a hole in it with an ice pick" to try to relieve the noise. Depending on the clinical situation, some patients received a second course of four injections 3 months after the first course. To those patients in the lidocaine-RHB-soft laser group, a daily intravenous infusion of 40 mg lidocaine plus 250 ml physiological saline, combined with physiotherapy and soft laser (for softlaser specifications, see earlier in this paragraph), were given for 10 days. It turns out that those ephisodes of hearing music were actually musical seisures which are extremely extremely rare and the scan showed that I had a brain tumor.
However, now Ive learned to enjoy it and even call it angel music to convince myself its a good thing!!
I found out through researching that it was a condition called tinnitus and had learned to live with it, as it subsides at times. Our results indicate that in high-tone tinnitus, the effects were poor, but they were good for low-pitched tinnitus.
I dont mean to scare you, I am fine now completely heathy but my advice is to listen to your body if you think you know something is wrong find a good doctor that will do everything to help you including psychological tests and a CT scan just to be safe. None of the treatment modalities had an objective correlate of improvement, though improvement was reported by a visual analog scale. Burcon’s information, I sought help from an upper cervical chiropractic specialist who confirmed a very poor range of motion and misalignment from the whiplash!

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