Non-Ambulatory TBI Patient with a 17-year History of Headaches

Background: A 56 year-old female patient presented to Plasticity Brain Centers with excruciating headaches and head pressure that has been present for 17 years after an head injury. She was unable to walk unassisted when she initially presented into the clinic.

Examination: The patient presented with a symptom count of 23/27 and a symptom severity of 98/162. During balance testing, on a perturbed surface with the head turned to the right with eyes closed, the patient overall stability score was 43.9%. Gaze stability after vertical saccades was greatly affected, with numerous spontaneous movements after each vertical movement. During saccadometry testing, the latency mean of leftward saccades was 225 ms and peak velocity mean was 489°/s.

Results: The patient was treated over a 4-day span that included gaze stability exercises, repetitive peripheral somatosensory stimulation, chair rotations, and divergent eye exercises. After the first day of treatment, the patient was able to walk unassisted. The patient had a symptom count of 18 and symptom severity of 34/162, after treatment (65% improvement). Her stability on the perturbed surface in head right position with eyes closed increased to 68.5%. Vertical saccades showed greatly improved stability after each eye movement. Peak velocity mean of leftward saccades during saccadometry increased to 555°/s and the latency mean decreased to 166 ms.

Conclusion: The rapid improvement of balance and neurological function indicate that brain-based treatment can be effective in the management of post-concussive symptoms including balance issues and headache.

#handicap #tbi #wheelchair #saccadometry #posturography #balance #headache

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