Utilization of Saccadometry in an Intensive Multimodal Neurological Approach to a Patient with Headaches and Cognitive Impairments
Presentation: A 39 year old medical professional presented with headaches, difficulty concentrating, difficulty remembering, fatigue, feeling “in a fog”, and increased emotionality. Each of these were 6/6 on subjective symptom assessment. The patient was evaluated diagnostically by the use of saccadometry. Saccadometry is the evaluation of saccadic eye movements using infrared laser technology. Saccadometry quantifies the latency, position, velocity, and amplitude of saccade. Each diagnostic session consisted of 50 saccades 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 consisted of gaze stability exercises, repetitive peripheral somatosensory stimulation of the tongue and face, breathing exercises, and complex limb movements.
Results: The peak velocity means before treatment was 681 deg/s to the left and 781 deg/s to the right. The amplitude mean of rightward saccades was 17.0 deg. After treatment, the peak velocity means were 991 deg/s to the left and 1043 deg/s to the right (Z scores of 7.58 and 6.13, respectively). The amplitude mean of rightward saccades increased to 19.6 deg.
Conclusion: The saccadic velocity waveform should be uniform without transient acceleration or deceleration sequences. The rapid improvement velocity waveforms and phase plots demonstrate a significant patient outcome. The patient experienced reduced severity of symptoms after treatment. This suggests that an intensive neurological treatment approach 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.