Background: We describe a 27 year old female who presents with a seven year history of concussions. She complains of headaches, fatigue, memory and concentration problems, nausea, depression and speech difficulties.
Methods: A diagnosis of a centrally maintained vestibulopathy secondary to a mild traumatic brain injury was confirmed by examination. Aberrant gaze fixation, saccades and pursuits were observed and confirmed by videonystagmography. A negative center of pressure with a rightward bias was recorded upon a Comprehensive Assessment of Postural Systems (CAPS) unit. The patient participated in a neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, somato-sensory evoked potential stimulation of the right trigeminal system, times-one viewing gaze stabilization exercises, specific oculomotor rehabilitation therapies and application of low-level laser over the suboccipital musculature.
Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.
Conclusion: This case of a mild traumatic brain injury showed significant improvements as a result of a multimodal neurorehabilitation regimen as described. The authors suggest further investigation into the mechanisms of the vestibular rehabilitation and brain-based approaches to patient treatment with mild traumatic brain injuries.