Improvements in Cognition Following Neurological Rehabilitation for a 58-year-old Female with Central Vestibulopathy

Matthew M. Antonucci1, Emily R. Kalambaheti1, Megan Manno1, Brittany Forrester1 and Derek A. Barton1*

1Plasticity Brain Centers, United States

Presentation: A 58-year-old female presented to Plasticity Brain Centers for evaluation and treatment of central vestibulopathy following dizziness and vertigo of idiopathic origin. Her symptoms included dizziness, pain in the jaw, lightheadedness, and balance problems.

Findings: During intake, her Trails A time was 45.9 seconds (50th percentile equals 24.4 seconds); Trails B time was 89.4 seconds (50th percentile equals 47.1). On the standardized assessment of concussion, she scored 27 out of 30. Her digit symbol matching score on the processing speed test was 44 in 120 seconds (50th percentile being 56). On the King Devick (Galleta 2015) (Olson 2017) 3-card baseline test, she received a score of 75.2 seconds.

Methods: A 5-day, multi-modal program of neurological exercises was administered in 10 one-hour treatment sessions (Carrick 2017) that consisted of repetitive peripheral somatosensory stimuli, neuromuscular reeducation exercises, vestibular rehabilitation exercises, orthoptic exercises, cognitive exercises, and off-vertical axis rotation (Gdowski 1999) utilizing a multi-axis rotational chair (MARC).

Outcome: Upon exit, her Trails A time (Salthouse 2011) decreased to 22.7 seconds (-50.5447%); Trails B time decreased to 54 seconds (-39.5973%). The standardized assessment of concussion score increased to 29/30 (+10.3448%). Her digit symbol matching score was 54 (+18.5185%). King Devick score decreased to 62.2 seconds (-17.2872%).

Conclusion: The authors suggest further investigation into multi-modal, intensive approaches to improve cognition and oculometrics in patients with central vestibulopathy.


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