This 24 year-old professional hockey player presented to Plasticity Brain Centers after sustaining two head injuries while playing hockey. His primary complaints were anxiety, difficulty with concentration, and balance issues.
Dr. Antonucci performed an examination and observed an abnormal vestibular-ocular tilt reflex, a 29 beat-per-minute increase in heart rate from a laying position to standing. This heart rate acceleration meets the definition of postural orthostatic tachycardia syndrome (POTS). He had an increased vein to artery ratio, and visual desaturation of the color red in his right eye. He had postural instability, and a fall, during balance testing. His eye tracking was deficient and saccadic in the vertical plane. These signs and symptoms are consistent with a centrally-maintained vestibular syndrome without vertigo.
This patient was treated over a 4-day period, which included gaze-stability vestibular rehabilitation exercises, orthoptic (eye) therapies, earth-vertical (yaw) axis rotation, and sensory-motor entrainment therapy utilizing an Interactive Metronome.
After the 4-day treatment program, he had improvement in his vein to artery ratio, visual saturation, a 66% improvement in postural stability, eye tracking, and anxiety.
The authors would like to thank Dr. Frederick Carrick and the Carrick Institute of Graduate Studies for the training and clinical neuroscience. The authors would like to also thank Dr. Marc Ellis for the temporary utilization of his facilities for which this patient was seen and treated. The authors would also like to thank Dr. Kelsey Brenner, Dr. Stuart Rutledge, Dr. Lon Kalapp, Dr. Eduardo Fontana, Dr. Benjamin Berendt for their assistance in patient treatment.
Antonucci Mm, Sass Bj, Sass Cm(2015). Multimodal Neurological Approach To A Professional Athlete With Anxiety And Post-Concussive Syndrome. Front. Neurol. Conference Abstract: International Symposium On Clinical Neuroscience: Tbi And Neurodegeneration. Doi:10.3389/Conf.Fneur.2015.58.00075