RECALIBRATION OF SEMICIRCULAR CANAL INTEGRATION THROUGH REPOSITIONING TO AID IN RECOVERY FOLLOWING MILD TRAUMATIC BRAIN INJURY (mTBI)
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1
Carrick Institute for Graduate Studies, United States
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2
NeuroWorks Healthcare LLC, United States
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3
Kungälvs Kiropraktor Center AB, Sweden
Background: Young man with on going post concussion symptoms following a head trauma. His symptoms are debilitating to the point where he can only perform a couple of hours of work before becoming exhausted. He has symptoms of fatigue, head pressure, dizziness, feelings of fogginess which is worse at night. When sleeping he feels dizzier when lying on stomach. Medications included thyroid and growth hormones.
Objective: A neurological examination was performed including dynamic computerized posturography (CDP) and videonystagmography (VNG). Of significance he had diaphoresis of the feet more than hands, positive percussion myotonia, hypertensive blood pressure, and within normal limits (WNL) heart rate (seated, supine, standing), pendular patellar reflexes, decreased right arm swing with gait, and feet, right convergence spasm. He had a negative Dix-Hallpike maneuver when testing posterior canal involvement. His balance reduced with head extension testing. VNG testing had little abnormality. CDP did not support anterior canal involvement with head flexed testing (despite being dizzy when laying on stomach). Bead string, complex cerebellar active and gaze stabilization were given along with, anterior repositioning exercises secondary to symptoms.
Results: Anterior canal repositioning maneuver helped reduce autonomic involvement with diaphoresis of palms and feet, his arm swing returned and his sensorium felt better. This along with bead string saccadic exercises his convergence spasm was corrected. He was less fatigued and able to concentrate better, although minor symptoms lingered.
Conclusion: Canal repositioning maneuvers may help to reset cortical and brainstem integration. Further investigation should be performed to evaluate recalibration through graded repositioning of semicircular canals.
Acknowledgements
Authors would like to give thanks to Michael Drzewiecki for helping with this case.
Keywords:
Vestibular Rehabilitation,
semicircular canal,
recalibration,
Repositioning maneuver,
Mild Traumatic Brain Injury (mTBI),
dysautonomia
Conference:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration, Orlando, Florida, United States, 10 Dec - 14 Dec, 2015.
Presentation Type:
Poster Presentation
Topic:
Clinical aspects of TBI and Neurodegeneration
Citation:
Behrendt
BR,
Sockander
L and
Rayo
A
(2015). RECALIBRATION OF SEMICIRCULAR CANAL INTEGRATION THROUGH REPOSITIONING TO AID IN RECOVERY FOLLOWING MILD TRAUMATIC BRAIN INJURY (mTBI).
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration.
doi: 10.3389/conf.fneur.2015.58.00008
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Received:
01 Nov 2015;
Published Online:
02 Nov 2015.
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Correspondence:
Dr. Benjamin R Behrendt, Carrick Institute for Graduate Studies, Cape Canaveral, FL, United States, drben@neuroworkshealthcare.com