ABSTRACT: IMPROVEMENT IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME IN A PATIENT WITH MULTIPLE CONCUSSIONS AND POST-CONCUSSION SYNDROME
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Dr. David Schiller, United States
Background: A 19-year-old male with a history of 8 concussions between September 2009 and March 2015 presented to a private practice with symptoms of fatigue, headaches, inability to focus and sustain attention and what the patient described as “head fatigue.” Post-concussion syndrome was diagnosed at a local sports medicine clinic and children’s hospital.
Method: Neurological examination revealed dysautonomia specifically Postural Orthostatic Tachycardia Syndrome (POTS), with a rise in heart rate from 76 to 106 using a pulse meter. Examination also revealed light sensitivity in the right eye with facial muscle activation during testing, mild intention tremor with finger to nose assessment on the left, aberrant optokinetic responses (OPK), pursuits and saccades. Halmagyi testing of vestibuloocular reflex (VOR) was not tolerated. The patient participated in a 2 week vestibular rehabilitation program which included specific eye movement exercises, extra spinal manipulation, and Spinal Manipulative Therapy (SMT).
Results: the signs of POTS normalized during the treatment period and the patient reported a reduction in severity of headaches . The aberrant OPK, pursuits, and saccades improved. The patient was also able to tolerate some head movement without producing symptoms.
Conclusions: Vestibular rehabilitation has the ability to improve dysautonomia such as POTS and address the symptoms of post-concussion syndrome. The author suggests further investigation into multimodal vestibular rehabilitation methods in the treatment of post concussion syndrome.
Keywords:
concussion,
concussion rehabilitation,
Traumatic Brain Injury,
post concussion symptoms,
Post concussion syndrome,
Postural Orthostatic Tachycardia Syndrome,
Vestibular Rehabilitation
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:
Schiller
D
(2015). ABSTRACT: IMPROVEMENT IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME IN A PATIENT WITH MULTIPLE CONCUSSIONS AND POST-CONCUSSION SYNDROME.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration.
doi: 10.3389/conf.fneur.2015.58.00067
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Received:
25 Oct 2015;
Published Online:
02 Nov 2015.
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Correspondence:
Dr. David Schiller, Dr. David Schiller, Avon, CT, United States, drschiller@comcast.net