Introduction
A 28-year-old male presented to CFNC with nausea, exercise intolerance, headaches, trouble sleeping, noise sensitivity and light sensitivity following six diagnosed concussions. He experienced unexplained anxiety with overexertion in physical activity.
Examination
The patient was diagnosed with post-concussion syndrome, HPA axis dysfunction and blood sugar dysregulation.
Treatment
Recommended treatment for the patient was neurological rehabilitation twice a week for five weeks, followed by a re-evaluation. In conjunction with functional neurological rehabilitation, the patient underwent 10 hours of hyperbaric oxygen therapy. The patient was given nutritional advice to begin blood sugar management, support the HPA axis and address neurological inflammation.
Results
At the first re-examination, the patient reported improved exercise tolerance, nausea, light/noise sensitivity and sleep. He also no longer experienced headaches; however, energy levels throughout the day remained low. After this re-examination, the patient was given an at-home neurological exercise regimen. The patient then underwent another round of treatment consisting of one-hour weekly visits for four weeks, followed by another re-examination.
After the second round of treatment, the patient reported feeling better. He was able to do more exercise and perform up to 20 minutes of physical activity without symptoms. He was mostly asymptomatic but wanted to see further exercise tolerance.
At this point in care, the patient was completing an at-home neurological exercise regimen. We referred him to a functional neurologist to evaluate additional metabolic factors for symptomatology and exercise tolerance. During this time, the patient came in every four to six weeks for four check-in visits.
He reports global improvement of symptoms, is able to increase his physical activity up to 30 to 40 minutes, and continues to improve daily.
Conclusion
Functional neurological care, hyperbaric oxygen therapy and functional medicine have been shown to be effective in treating post-concussion syndrome. Patients require an individualized approach and targeted treatment to achieve optimal results.