A 28-year-old Female With Primary Complaint Of Small Intestinal Bacterial Overgrowth Is Treated Using A Novel Brain-based And Vestibular Approach To Full Resolution Of Gastrointestinal Symptomatology.
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Dr. Shannon Leon Functional Neurology, United States
Background
Small intestinal bacterial overgrowth (SIBO) is defined by excessive bacteria in the small intestine leading to multifarious symptoms, including bloating, abdominal pain, nausea, diarrhea, malabsorption, fatigue, and more. There remains a lack of consensus concerning the etiology of the condition and therefore a lack of standardization for the tests and therapy regarding the condition’s many manifestations. A 28-year-old female presents to our functional neurology clinic with chief complaint of SIBO, and prior diagnoses of Lyme’s Disease (7 years of age), Bell’s Palsy, arrhythmia, and a second Lyme’s Disease (21 years of age). Concurrent symptomatology include brain fog, transient body pain, cold hands and feet, headache, near-faint dizziness, and depression. Patient is referred to our clinic by her current Functional Medicine Nutritionist. Patient had been under the nutritionist’s care for three months at the time of her initial appointment to our clinic.
Methods
Comorbidities concerning the alimentary canal and the immune system have crossroads only in the central nervous system. Detailed neurological examination is conducted to assure the role of central processes in manifestation of distal, distinct systems. Vital signs are as follows: blood pressure seated is 115/74 in the right and 110/74 in the left, while standing it is 111/77 in the right and 108/73 in the left; pulse seated is 75 beats per minute bilateral, and standing is 83 BPM in the right and 81 BPM in the left; oxygen saturation is 98% in the right and 99% in the left; stethoscopic exam reveals one beat of arrhythmia per thirty seconds with right head yaw. Bedside neurological examination reveals left head tilt, left corectasia, left accommodation spasm, hypomimia distributed along right V2 branch musculature, hypermetric saccades rightward, Weber’s test lateralization left, finger to nose within normal limits, smooth pursuits horizontal though with blink and V2 branch twitch during left-to-right motion, resting nystagmus left beat, eccentric gaze hold reduced time constant in the right horizontal (two seconds) and right vertical (two seconds), somatic vibration sense equal bilateral in upper and lower extremities, corneal reflex is brisk bilateral, gag reflex is brisk on the right and absent on the left, and muscle stretch reflexes on the left induce spreading muscular recruitment. Gait analysis exhibits decrease in amplitude of right arm swing and a decrease of right side stride length. Dynamic posturography confirms decrease stability within the right posterior semicircular canal and bilateral otolith organs. Videonystagmography confirms left accommodation spasm, decreased rightward vestibulo-ocular reflex amplitude and frequency, and leftward vestibulo-ocular reflex internuclear ophthalmoplegia. A brain-based, multimodal treatment plan included vestibular rehabilitation maneuvers, vestibulo-ocular re-training, specific eye movement therapies, and personalized plant-based nutrition plan.
Results
Following initial treatment patient reports less dizziness, no faintness upon standing, and improved affect. Patient was seen twice per week for three months and has since elected maintenance care until present day. Almost two years since patient initially reports to our clinic she continues to report little to no effect of previous SIBO symptomatology. Her ongoing care focuses dynamically on consequences of early life immune system compromise.
Conclusion
Patient presentation of indiscriminate medical specializations require thorough investigation into central neural processes in order to elucidate etiology and to focus care. A 28-year-old female presents to our functional neurology clinic with chief complaint of SIBO, with two prior diagnoses of Lyme’s Disease, Bell’s Palsy, arrhythmia, and further comorbidities, and she sees immediate attenuation of symptomatology with a continued trend toward optimal health using a brain-based, multimodal treatment approach. Further investigation is warranted for interventions involving brain-based therapies for SIBO, leaky gut, and other systemic disorders.
Keywords:
small intestinal bacterial overgrowth,
Brain Based Rehabilitation,
Vestibular Rehabilitation,
Lyme Disease,
Bell's palsy
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Leon
S,
Case
M and
Langhough
J
(2018). A 28-year-old Female With Primary Complaint Of Small Intestinal Bacterial Overgrowth Is Treated Using A Novel Brain-based And Vestibular Approach To Full Resolution Of Gastrointestinal Symptomatology..
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00056
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Received:
30 Mar 2018;
Published Online:
14 Dec 2018.
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Correspondence:
Dr. Jason Langhough, Dr. Shannon Leon Functional Neurology, Woodbury, NY, 11797, United States, j.langhough@gmail.com