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January 18, 2018

The Three Subtypes of Post-Concussion Syndrome and How They’re Treated

Post-concussion syndrome (PCS) is a condition when a set of symptoms associated with a concussion persist for more than three months. PCS is a serious condition that puts the patient at increased risk of developing second impact syndrome (SIS) if they suffer another concussion while the symptoms of the previous concussion, or the persistent symptoms associated with PCS, are still present. A functional neurologist  can help patients recover from PCS by using the brain’s own plasticity, but first we need to understand the patient, and that begins with determining from what subtype of PCS the patient is suffering.

PCS Subtypes

PCS iso often broken down into three subtypes, referred to as post concussive disorders (PCD). The three types of PCD are physiological PCD, vestibulo-ocular PCD, and cervicogenic PCD. But there is also a fourth type of PCD -- the mixed type, in which a person can have multiple or all three types of PCD. Once the type of PCD is known, the appropriate therapies can be administered to help the patient overcome their PCS.

Physiological PCD

Physiological PCD is characterized by a reduction in the use of glucose by the brain and altered cerebral blood flow due to autonomic nervous . Symptoms generally associated with physiological PCD include headaches that worsen with physical and cognitive activities, dizziness, slowed speech, light and sound sensitivity, nausea, fatigue, and difficulty concentrating. During a physical examination, elevated resting heart rate can indicate physiological PCD. Treatments for physiological PCD include school accommodations (for students), physical and cognitive rest, as well as aerobic exercise that doesn’t exacerbate symptoms.

Vestibulo-Ocular PCD

Vestibulo-ocular PCD is characterized by symptoms that correlate to the vestibular and oculomotor systems. Symptoms associated with vestibulo-ocular PCD include headaches that worsen with reading, visual tracking issues, nausea, vertigo, dizziness, motion sickness, and blurred or double vision. During a physical examination, impaired vestibulo-ocular reflex, balance and gait issues, and difficulties with convergence and saccadic eye movements can help diagnose vestibulo-ocular PCD. The best treatments for addressing vestibulo-ocular PCD include school accommodations (for students), vestibular rehabilitation, vision therapy, as well as aerobic exercise that doesn’t exacerbate symptoms.

Cervicogenic PCD

Cervicogenic PCD is characterized by muscle trauma and inflammation caused by the cervical spine somatosensory system. Symptoms typical of cervicogenic PCD include occipital headaches that worsen with head movements, lightheadedness, postural imbalances, and neck pain and stiffness with decreased range of motion. During a physical examination, tenderness in the paraspinal and suboccipital muscles and decreased cervical range of motion can help diagnose cervicogenic PCD. Treatment options for cervicogenic PCD include chiropractic adjustments to the cervical spine, balance and gaze stabilization exercises, as well as aerobic exercise that doesn’t exacerbate symptoms.

As you can see, while light aerobic exercise is often used as a blanket treatment to treat each subtype of PCS, the other treatments vary greatly and each address different problems that are exclusive to each subtype of PCS. The doctors at Plasticity Brain Centers are some of the best-equipped doctors to diagnose and treat the various subtypes of PCS.  Contact Plasticity Brain Centers today for more information or to schedule an appointment with one of our doctors.

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