Benign paroxysmal positional vertigo (BPPV) following a concussion.
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1
Nathan Keiser DC, LLC, United States
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2
Carrick Institute, United States
Objective: Symptomatology and neurological improvements in a hockey player suffering from post-concussive syndrome (PCS) following an intensive multi-modal neuro-rehabilitation program is described.
Clinical Features: The subject is an 18-year-old male suffering from the symptoms of BPPV following a concussion sustained in a hockey game. Symptomatology included vertigo, nausea, dizziness, difficulty concentrating, and headaches. A neurological evaluation revealed a positive Dix-Hallpike test for the left posterior canal, global hyporeflexia, abnormal gait with dual tasking, aberrant optokinetic responses (OKR) on videonystagmography (VNG), and disturbances in balance with computerized dynamic posturography (CDP).
Interventions and Outcomes: A patient specific protocol was designed utilizing a combination of electrical stimulation protocols, neuromuscular re-education, vestibular rehabilitation and optokinetic exercises. The patient was treated seven times in five days. Pre and post CDP testing was performed standing with feet parallel to a line and perturbation of head in neutral, pitched forward, backward, right and left yaw. Pre and post findings were noted showing an upward trend in stability scores. VNG showed improved OKR. Gait abnormalities with dual tasking, and global hyporeflexia also showed improvement. Symptomatology associated with BPPV showed significant improvement.
Conclusion: Utilizing findings from a functional neurologic examination, an intensive multi-modal neuro-rehabilitation program was developed and implemented to address functional deficits following PCS. In response to the five-day treatment, the subject demonstrated significant subjective and objective improvement. The results of the study are limited to a single patient and further research is encouraged to determine if results can be replicated in similar conditions.
Keywords:
post concussive syndrome,
PCS,
BPPV,
MTBI,
vestibular,
balance,
Vertigo,
Dizziness,
Neuro rehabilitation,
chiropractic neurology
Conference:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration, Orlando, Florida, United States, 10 Dec - 14 Dec, 2015.
Presentation Type:
Poster Presentation
Topic:
Case Reports for Poster Presentation
Citation:
Kempinski
TL and
Keiser
ND
(2015). Benign paroxysmal positional vertigo (BPPV) following a concussion..
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration.
doi: 10.3389/conf.fneur.2015.58.00061
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Received:
28 Oct 2015;
Published Online:
02 Nov 2015.
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Correspondence:
Dr. Thomas L Kempinski, Nathan Keiser DC, LLC, Atlanta, Georgia, United States, drtkempinski@gmail.com
Dr. Nathan D Keiser, Nathan Keiser DC, LLC, Atlanta, Georgia, United States, dockeiser@gmaii.com