Focal dystonia and greater occipital neuralgia secondary to post concussion syndrome in a professional hockey player.
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1
Innova Brain Rehabilitation, United States
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2
Carrick Institute of Graduate Studies, United States
Objective: Demonstrate resolution of focal dystonia, greater occipital neuralgia, and post concussive symptoms following neuromuscular re-education and vestibular rehabilitation program.
Clinical Features: Male subject was 25 years old with a history of four concussions since the age of 17. Most recent concussion occurred with a blind-sided hit to the right side of his head leading to his current symptomatology. Subject reported difficulties with headaches, fogginess, head pressure, fatigue, neck pain, and a long standing low back pain extending in to left buttock and the posterior compartment of the left lower extremity. He also reported a history of three surgeries for femoroacetabular impingement syndrome on his left and one on his right. Examination revealed irregular optokinetic responses (OKR), catch up saccades with rightward pursuits, abnormal eye-head saccades, a positive slump test, and decreased speed of finger-tapping test (FTT) on the right and Grade I on the left on the unified Parkinson’s disease rating scale (UPDRS).
Interventions and Outcomes: A five day treatment protocol was implemented incorporating vestibular rehabilitation neuromuscular re-education and sport-specific athletic drills. Marked improvement after the protocol was observed with: normalized OKR, negative slump test with mild right-sided tightness, and normalized pursuits, FTT, and eye-head saccades. The patient noted resolution of headaches, fogginess, head pressure, fatigue, neck pain, and low back pain.
Conclusions: Intensive rehabilitation addressed signs and symptoms in a patient with focal dystonia of the hip extensors, as well as occipital neuralgia secondary to post concussion syndrome. The subject demonstrated significant improvements subjectively and objectively after five days of therapy. Further investigation may establish a therapeutic approach for other individuals with greater occipital neuralgia, focal dystonia and/or post-concussion syndrome.
Key Words: Post concussion syndrome, PCS, vestibular rehabilitation, neuromuscular re-education, dystonia, greater occipital neuralgia, femoroacetabular impingement, hip impingement.
Keywords:
Post concussion syndrome,
PCS,
Vestibular Rehabilitation,
Neuromuscular re-education,
Dystonia,
Greater occipital neuralgia,
Femoroacetabular impingement,
hip impingement.
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:
Patterson
FE and
Keiser
ND
(2016). Focal dystonia and greater occipital neuralgia secondary to post concussion syndrome in a professional hockey player..
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function.
doi: 10.3389/conf.fneur.2016.59.00089
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Received:
02 Sep 2016;
Published Online:
07 Sep 2016.
*
Correspondence:
Dr. Nathan D Keiser, Innova Brain Rehabilitation, Marietta, Georgia, United States, dockeiser@gmail.com