Background: A 28-year-old male presented with complaints of fatigue, hyperacusis and acquired dyslexia. Significant history included a past diagnosed of post-concussive syndrome The patient stated that he would view the treatment as successful if the symptoms were reduced by 40%
Methods: Neurocognitive testing using a concussion management system (C3Logix) was used to reliably and objectively assess the patient’s physical findings and delivered. This testing revealed a symptom severity score of 62/162. Computerized dynamic posturography (CDP) was used to quantify and differentiate between possible sensory, motor and central adaptive impairments to balance control. This subject’s stability score was 84.4% with eyes open on a solid surface and 78.9% with eyes open on a perturbed surface.
Functional tests revealed a dynamic right hypertropia, failed convergence on the right, left ptosis with left corectasia. Optokinetic stimulation revealed a right beating post pursuit nystagmus which was confirmed by videonystagmography (VNG). The VNG also revealed right square wave jerks in right gaze with increased blinking and hippus in upward gaze. Further examination revealed bilateral decrease in arm swing during gait analysis, decrease in left palate tone, slow capillary refill on the left hand and decreased right biceps tendon reflex. Dysmetria was also present on a finger-to nose-test with the left arm less accurate than the right.
Therapeutic intervention consisting of nerve stimulation, vision therapy, vestibular rehabilitation, cognitive exercises, chiropractic adjustments and multi-axis rotational therapy were administered 3-5 times per day for 5 consecutive days.
Results: After the 5 day treatment plan, neurocognitive testing was repeated and showed a 69% decrease in the symptom severity score. The patient had a significant decrease in all subjective complaints and showed significant improvement in all positive exam findings.
Conclusion: A novel patient centered treatment program improved objective and subjective measures. More research is needed into the use of integrated therapies in the treatment of post-concussion syndrome.