There is no one size fits all treatment applications for concussions. The symptoms one suffers is dependent on the pre-existing health, number and type of head injuries. Some may develop dizziness, migraines, vertigo, confusion, brain fog, fatigue, and more. An area of the brain known as teh vestibular system and cerebellum via the Vestibuloocular Reflex control the ‘stability’ of eye movement and you may also suffer from disequilibrium, blurry, or double vision and more.
The PCS program consists of a 2-hour initial evaluation which translates into an individualized treatment plan for each patient depending on their symptoms and diagnostic results and includes:
Full neurological exam,
Balance, Gait exam
Computerized Brain Function testing
Videonystagmography (VNG) balance/ vestibular test
Autonomic Testing and measurements of Vagus and heart rate variability
- Pons stimulation,
- Vagus nerve,
- Trigeminal stimulation.
- Vestibular Rehab
- Neurosensory Integrator
- Cognitive rehab
- Balance and gait training
- Interactive Metronome
TRANSCRANIAL DIRECT-CURRENT STIMULATION (tDCS)
- Galvanic (tDCS) is unlike any other current
- Has polarity specific effects on neurons.
- Changes firing threshold and can produce long lasting after effects.
- Causes neurons to fire by increasing “neuronal excitability”
- These impulses travel throughout the brain and activate or reactivate neurons and structures involved in human function.
ex. targeting with moving background to stabilize images to improve blurred images, moving background or objects, balance, nausea and headaches.
Neurosensory integrator – Neurocognitive exercises, visual vestibular eye hand exercises on a 55′ screen progressing on different different surfaces, auditory visual, speed span recognition and more
DYSAUTONOMIA & concussion
One of the most common symptoms in concussion are symptoms of dysautonomia via the Vagus nerve. Dysautonomia is a broad term that is used to describe a condition associated with the autonomic nervous system. The most common is Postural Orthostatic Hypotension Syndrome known as P.O.T.S. Patients with P.O.T.S. experience an abnormal jump in their heart rate when elevating from a supine (lying) position in order to get blood to their brain. If this reflex doesn’t respond correctly you could experience dizziness or fainting because of decreased blood flow to the brain.
This relationship between eye and neck muscle activity influences muscle coordination and tone during functional activities, such as reading, walking, cognition and results in muscle spasms resulting in headaches all due to a sensory mismatch.
Symptoms of dysautonomia may include:
Syncope (fainting/near fainting)
Tachycardia (fast heart rate)
Bradycardia (slow heart rate)
Low Blood Pressure
Shortness of Breath
Temperature Regulation Problems
Inability to concentrate
Difficulty with recall
Hypersensitivity to sensory stimulation
New research suggests that this inappropriate response is due to aberrant firing of or denervation at the Nucleus Tractus Solitarius (NTS), located in the brainstem. Symptoms of orthostatic hypotension include exercise intolerance, excessive fatigue, thirst, lightheadedness, dizziness, anxiety, internal tremulous (also known as orthostatic tremor), sweating, nausea, irritable bowel, brain fog, tinnitus, headaches and more. Unfortunately because these symptoms occur most commonly in women they’re often dismissed as Chronic Fatigue Syndrome or an anxiety based panic disorder.
Changes in blood pressure and heart rate can be due to many things. The lack of activation or stimulation which causes changes in a cell is what leads to decreased metabolic activity in the cell. Tilt table testing signals the baroreceptor which fires into the NTS letting it know of the changes so that it can respond by firing into the sympathetic system to steadily increase heart rate and blood pressure accordingly. When a cell is sitting too close to threshold a slight stimulus comes in and the cell responds inappropriately resulting in an inappropriate response.