Late Whiplash Syndrome Complicated by Ehlers-Danlos

This case study illustrates the clinical complexity of managing a whiplash patient with Ehlers-Danlos syndrome (EDS), a condition characterized by joint hypermobility. A young male presented with severe headaches (8-9/10) following a rear-end collision. Despite only minor initial symptoms, he developed an unsteady gait, positive Romberg sign, and Hoffman’s sign—indicators of an upper motor neuron lesion. Testing on the Beighton scale confirmed hypermobility in his elbows and fingers, which significantly increases the risk of post-traumatic complications.The sources highlight a critical diagnostic suspicion: cervical artery dissection (CAD). Patients with EDS are more prone to CAD following trauma, and the patient’s neurological deficits and severe "aching" headache were classic red flags. The treating chiropractor correctly deferred spinal manipulation—which is contraindicated in the presence of an unstable spine or suspected dissection—and referred the patient to the emergency department for specialized imaging. This article serves as a vital reminder for chiropractors to perform thorough histories and physical exams following cervical injuries, specifically screening for hypermobility and neurological signs that suggest life-threatening vascular or structural instability.