A 16-year-old male presented to the clinic with lingering symptoms of headaches, brain fog, light sensitivity, decreased appetite, and emotional dysregulation following a concussion that he sustained two and a half months prior.
Examination and Diagnosis
Physical examination and diagnostic testing identified fluctuations in oxygen saturation, pupillary hippus, anisocoria, convergence excess, positive red desaturation, sluggish pupillary light reflex, impaired vertical tracking, gaze instability in all planes, and diminished arm swing during gait. The patient was diagnosed with post-concussion syndrome.
Treatment
The patient was initially treated for 12 visits over the course of 9 weeks with 10 hours of mild hyperbaric oxygen. The initial course of treatment consisted of diaphragmatic breathing exercises, cranial nerve neuromodulation, transcutaneous vagus nerve stimulation, oculomotor exercises, interactive metronome training, Go/No-Go activities, Eye-Hand activities, Red/NIR light therapy, and Bemer pEMF therapy.
A re-examination was performed and the patient was given exercises to perform at home on a daily basis. The patient was then advised to continue treatment at a frequency of 1 visit per week for 4 visits, followed by one visit every other week for 8 visits.
Results
Following the completion of the initial course of treatment the patient reported a 50% overall subjective improvement in symptoms with near complete resolution in headaches and significant reduction in brain fog, emotional dysregulation, light sensitivity, and appetite.
Re-examination revealed complete resolution of anisocoria, a normal pupillary light reflex, and moderate improvement in convergence excess, gaze stability, vertical pursuits, and gait associated arm swing.
Conclusion
Functional neurological rehabilitation and mild hyperbaric oxygen therapy have been shown to be effective in the management and treatment of post-concussion syndrome. An individualized plan of care and targeted treatment strategies are paramount to achieve optimal outcomes. Please contact us to learn more or schedule a consultation.