Headache and Cognitive dysfunction: A diagnostic and treatment perspective.
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1
Carrick Institute, United States
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2
Innova Brain Rehabilitation, United States
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3
Symmetry Health, Canada
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4
Woodbine Chiropractic Clinic, Canada
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5
Balance Health and Sports Therapy, Canada
Objective: Successful treatment of an individual with headache and cognitive dysfunction is described.
Clinical Features: A 58-year-old female presented for consultations in a chiropractic neurology facility with a history of bilateral frontal headaches and cognitive dysfunction following a motor vehicle collision. Chief complaints included difficulty concentrating, amnesia, brain fog, fatigue, difficulty falling asleep. Videonystagmography (VNG) and physical exam reveal failure of left eye adduction with convergence, horizontal square-wave jerks in vertical gaze and optokinetic responses (OKR). In-phase hypermetric square wave intrusions were present in horizontal and vertical pursuits, fast phase re-correction were absent on leftward and upward optokinetic stimulation. Gait abnormalities were observed with loss of left arm swing and dual tasking decreasing arm swing bilaterally.
Interventions and Outcomes: An intensive multi-modal neurorehabilitation protocol was designed utilizing electrical stimulation, vestibular rehabilitation, neuromuscular re-education over a 5 day period. Post-treatment VNG findings revealed an attenuation of jerks in vertical gaze and OKR. Horizontal and vertical pursuits and OKR were normal. Improvement in arm swing was also observed in both casual and dual-tasking gait, and subjective complaints of headache, brain fog, poor concentration and fatigue showed subjective improvement.
Conclusions: Utilizing findings from a functional neurological exam, an individual protocol of intensive multi-modal neurorehabilitation was devised and implemented. Following the execution of the protocol the subject had an improvement in symptomatology and neurological findings.
Keywords:
Headache,
cognitive dysfunction,
brain fog,
Neurorehabilitation,
Vestibular Rehabilitation
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:
Keiser
ND,
Scarborough
D,
Kwok
W,
Lee-Ying
I and
Nardella
A
(2016). Headache and Cognitive dysfunction: A diagnostic and treatment perspective..
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function.
doi: 10.3389/conf.fneur.2016.59.00074
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Received:
02 Sep 2016;
Published Online:
07 Sep 2016.
*
Correspondence:
Dr. Nathan D Keiser, Carrick Institute, Cape Canaveral, FL, United States, dockeiser@gmail.com