A 13 year-old female presented with POTS and intermittent vasovagal syncope. Her chief complaints were syncopal episodes, difficulty with motor coordination, numbness in legs, anxiety, chest pain, dizziness, headaches, and fatigue.
Examination and Diagnosis
A neurological examination revealed right cerebellar dysfunction, orthostatic intolerance, and a decreased cortisol awakening response.
The patient was initially treated three times a day for five days. Visits included tilt table therapy, orthostatic retraining, BEMER therapy, neuromodulation to the hypoglossal and trigeminal nerves, NIR light therapy, motor coordination tasks
After undergoing treatment the patient began an at-home regimen of individualized supplementation, as well as, morning & evening sleep/wake cycle routine, and at-home neurological therapies.
During the initial examination, the patient’s seated HR ranged from 70-90bpm bilaterally and her orthostatic HR increased from 67bpm to 115bpm upon standing and remained elevated above 110bpm. After treatment, the patient’s seated HR averaged 78bpm bilaterally and her orthostatic HR began at 73bpm and increased to 96bpm.
The patient went from experiencing 8/10 fatigue and 7/10 headaches daily to 3/10 fatigue and 2/10 headaches. Prior to treatment she would nap multiple times a day, now she naps a couple times a week. She was experiencing 3-5 syncopal episodes a day and it is now 2-3 per month.
After the treatment plan was completed the patient continued a maintenance plan of supplementation and continued at-home neurological therapies. The patient has scheduled telehealth calls for check-ins every 2 months.
Functional neurological care has been shown to be effective in the treatment of autonomic dysfunction. Please visit our Dysautonomia Program webpage for more information.