Introduction
A 29-year-old female presented with symptoms of tachycardia especially when changing positions, chest tightness/ squeezing, balance issues/ feeling like she was “on a boat,” upper back and neck pain, shakiness, anxiety and fatigue.
Examination and Diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS)
A neurological examination revealed Postural Orthostatic Tachycarida Syndrome (POTS) having an elevation in her heart rate against gravity from supine to standing of 83-156 bpm. The patient was diagnosed at our facility.
Treatment
The patient was initially treated with 1 intensive day per week for 2 weeks; this included three 1-hour sessions per day with two 30-minute breaks. We then saw her 2x per week for 1 hour for 6 consecutive weeks.
The second round of treatment following a re-evaluation the patient was seen 1x per week for 30 minutes for 8 consecutive weeks.
Treatment consisted of bilateral V3 neuromodulation to the hypoglossal and trigeminal nerves, tilt table therapy, vibration therapy to the upper back, eye movement therapy and chiropractic adjustments.
Results
After the initial round of treatment, the patient stated her heart rate with changes in position had improved 90% and the rest of her symptoms were approximately 75% improved. Currently she states the majority of her days are symptom free. She does notice that her heart rate can still be elevated more than normal in the mornings, but it does not have any effect on her day-to-day activities, i.e. it is not causing her any symptoms.
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.