Female athlete with postural orthostatic tachycardia syndrome secondary to multiple mild traumatic brain injuries experienced rapid improvement in functionality after multimodal brain-based therapy
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1
Portland Chiropractic Neurology, United States
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2
Life University, United States
Introduction:
We describe an 18-year-old female athlete who presented with postural orthostatic tachycardia syndrome (POTS) secondary to multiple mild traumatic brain (mTBI) injuries. Patient complained of dizziness, unsteadiness, and feelings of potential syncope. After mild physical activity, symptoms lasted up to an hour. She suffered multiple mTBI’s playing high school sports and symptoms resurfaced after she started running cross-country this year.
Methods:
A comprehensive neurological examination revealed a heart rate increase from 59bpm to 100bpm when she changed position from lying to standing. Tilt table testing revealed a 30-40 point increase in systolic heart rate at a 50-60 degree incline. The heart rate spike lasted 1-2minutes. Extraocular examination showed a significant convergence spasm of the right eye. The patient was treated 2-3 times a week for a duration of four weeks. Treatments included spinal manipulative therapy to the costosternal joint, tilt table treatment, and orthodromic somatosensory evoked potential nerve stimulation to the mandibular branch of the trigeminal nerve bilaterally on the tongue without head response recording.
Results:
The patient responded rapidly, showing improvements at each session. After 8 visits, tilt table testing showed stability of heart rate up to a 70-degree incline. At a 70-degree incline a mild heart rate spike was seen, from 75bpm to 85bpm that lasted 10 seconds. The patient stated that after physical activity, her symptoms were only present for one to two minutes or not at all.
Conclusion:
This case illustrates substantial improvements of patient symptoms as a result of multimodal neurorehabilitation. The authors suggest further investigation into the use of individualized brain-based treatments for patients with postural orthostatic tachycardia syndrome and mild traumatic brain injury.
Keywords:
Traumatic brain injury (TBI),
POTS,
Neurorehabilitation after Brain Injury,
Chiropractic,
Neurorehabilitation
Conference:
International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function, Orlando, United States, 7 Oct - 9 Oct, 2016.
Presentation Type:
Poster Presentation
Topic:
Abstracts ISCN 2016
Citation:
Brinidisi
D,
Brindisi
L and
Esposito
SE
(2016). Female athlete with postural orthostatic tachycardia syndrome secondary to multiple mild traumatic brain injuries experienced rapid improvement in functionality after multimodal brain-based therapy.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function.
doi: 10.3389/conf.fneur.2016.59.00001
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Received:
28 Aug 2016;
Published Online:
07 Sep 2016.
*
Correspondence:
Dr. Susan E Esposito, Life University, Marietta, United States, susanesposito@gmail.com