Introduction
A 38-year-old female presented with Postural Orthostatic Tachycardia Syndrome (POTS) for a year and a half. Her chief complaints were tachycardia, fatigue, anxiety, constipation and exercise intolerance. She was put on Florinef, Citalopram, salt sticks, and metoprolol.
Examination and Diagnosis
A neurological examination revealed a right-sided ponto-medullary deficit.
Treatment
The patient was initially treated with 1 intensive day per week for 2 weeks; this includes three 1-hour sessions per day with two 30-minute breaks. We then saw her 2x per week for 1 hour for 4 consecutive weeks.
She was also put on supplementation to aid in sleep/wake cycles, inflammation, vitamin D, electrolyte balance and stress modulation.
For the second round of treatment following a re-evaluation, the patient was seen 1x per week for 30 minutes for 7 consecutive weeks.
Treatment consisted of R V1, V2, V3 neuromodulation to the hypoglossal and trigeminal nerves, red/NIR light therapy, tilt table therapy, hyperbaric oxygen therapy and orthostatic re-training.
Results
After the initial round of treatment, the patient was off ALL prescription medications, GI symptoms were resolved, she was sleeping better, tachycardia was off and on, she was able to get out of bed without staying seated for 10 minutes, she could shower anytime without having to lay down after, she was working out daily and she cannot remember the last time she had to lay down and wasn’t able to do anything due to her condition.
Conclusion
Functional neurological care has been shown to be effective in the treatment of Postural Orthostatic Tachycardia Syndrome. Please visit our Dysautonomia Program webpage for more information.