Utilization of Saccadometry in a Multimodal Neurological Treatment Approach in a Patient with Increased Intracranial Pressure, Dysautonomia, and Cognitive Impairments

Presentation: A 44 year old medical professional with a history of increased intracranial pressure presented with daily pulsating headaches, pulsatile tinnitus, insomnia, and difficulty concentrating. His difficulty concentrating was his main complaint initially.

The patient was evaluated diagnostically by the use of saccadometry. Saccadometry is the evaluation of saccadic eye movements using infrared laser technology. The saccadometer quantifies the latency, position, velocity, and amplitude of each eye movement. Each diagnostic session consists of 50 eye movements to the left and 50 to the right.

Methods: The patient was treated over a four day span that included three treatment sessions per day that lasted an hour. The treatment utilized in this case consisted of gaze stability exercises, repetitive peripheral somatosensory stimulation of the tongue and face, chair translations, and the interactive metronome.

Results: The difference between peak velocity means before treatment was 132 deg/s (471 deg/s to the left and 603 to the right). After treatment, the difference between peak velocity means was 16 deg/s (530 deg/s to the left, and 514 deg/s to the right).

Conclusion: Repetitive saccadic eye movements should be reproducible. The rapid improvement in the scedasticity of velocity and phase waveforms demonstrate a significant patient outcome. The patient experienced increased concentration ability and cognitive function from therapy without dysautonomia on the final day of treatment. These findings suggest that the intensive neurological treatment approach utilized in this case and the diagnostic data provided by saccadometry are important clinical aspects in neurological rehabilitation.

Acknowledgments: The authors would like to thank Dr. Frederick Carrick and the Carrick Institute of Graduate Studies for the training and clinical neuroscience.

The authors would like to also thank Dr. Marc Ellis for the temporary utilization of his facilities for which this patient was seen and treated.

The authors would also like to thank Dr. Kelsey Brenner, Dr. Stuart Rutledge, Dr. Lon Kalapp, Dr. Eduardo Fontana, Dr. Ben Behrendt, and Matthew Leonard for their assistance in patient treatment.