15-year-old male with migraines and sleep disturbances after multiple concussions is treated to full resolution of symptoms
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Dr. Shannon Leon Functional Neurology, United States
Presentation
Patient presents with radiological reports noting “mild apex levoscoliotic curvature centered approximately at T11” and a “bone age of 15 years.” He is prescribed Elavil 10mg for sleep quality enhancement. History taking reveals three concussions in the past. Clinical examination highlights reveal increased palmar sweating, decreased saccadic velocity rightward, left ocular accommodation in neutral gaze, resting nystgamus with directionality up-left and down-right, balance instability with head tilt into right posterior semicircular canal, and a decreased right arm swing during gait that improves with dual tasking.
Intervention
Central neural integration is enhanced first with vestibular recalibration using a right Epley maneuver. Cervical joint juxtaposition is manually adjusted at the levels of C2 and occiput. Appendicular proprioceptive input is manipulated using multiplanars of the right lower extremity and uniplanars of the left upper extremity. Carrick Eye Exercises of remembered target saccades are used in patient’s upper right field of view with directionality up-right; Brock String is angled up-right; finger-nose-finger is performed in upper right field of view.
Outcome
Patient reports “no pain, sleeping well, and no migraines” following one treatment.
Perspective
A patient with so many chief complaints, like migraine, sleep disturbance, and bodily pain, need not seek as many specialists. Our clinic observed his biomarkers with centrally-mediated phenomenology - with especial localizing weight attributed to vestibular and ocular concomitants - and used them to equilibrate his asymmetric, inefficient, and paradoxical reflexes. This clinical method of realtime observation-to-treatment is given scientific credence from evidence-based clinical outcome assessment tools, namely PHQ-15 and Epworth Sleepiness Scale, and affirmed effective from patient satisfaction.
Keywords:
Post concussion syndrome,
concussion,
Migraines,
Sleep disturbance,
carrick eye exercises
Conference:
International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019.
Presentation Type:
Poster Presentation
Topic:
Clinical Neuroscience
Citation:
Leon
S and
Langhough
J
(2019). 15-year-old male with migraines and sleep disturbances after multiple concussions is treated to full resolution of symptoms.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience.
doi: 10.3389/conf.fneur.2019.62.00028
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Received:
30 Mar 2019;
Published Online:
27 Sep 2019.
*
Correspondence:
Dr. Jason Langhough, Dr. Shannon Leon Functional Neurology, Woodbury, Minnesota, 11797, United States, j.langhough@gmail.com