Case Studies

Research + Findings

These case studies have been designed to share more about individuals with specific conditions, the treatments available and our results.

IMPROVEMENT IN ACHALASIA FOLLOWING A NEUROLOGICAL REHABILITATION PROGRAM

George Michalopoulos, Fili Talamantez and Derek Barton | Illinois Neuro and Physical Rehabilitation, United States, Carrick Institute, United States | Front. Neurol. Conference Abstract. 2016.

Background: A 32-year-old female patient presented to a functional neurology practice with complaint of achalasia that came on 10 years prior. The patient had previously used surgical intervention to manage the condition with some success, however, her condition began to worsen over the past several months before her visit. The patient presented with complaints of difficulty swallowing and digesting food. Barium swallow studies showed persistence of contrast agent in the esophagus after five minutes.

Methods: Neurological examination revealed left beating nystagmus. Pursuits had saccadic intrusions with eye movements up and to the right and down and to the left. The patient had decreased amplitude of optokinetics to the left. The patient had absence of her gag reflex and finger to nose was dysmetric on the right. The patient was diagnosed with achalasia. A treatment plan consisting of intense parasympathetic stimulation and brain-based therapy was implemented. The patient performed manual stimulation of the gag response, gaze stability exercises, complex movements of the extremities, and vibration exercises on the left side.

Results: The patient reported improvement in her ability to swallow and digest food. A follow-up barium swallow study showed the patient was able to clear the contrast in under one minute.

Conclusions A patient scheduled for esophageal surgery finds relief through conservative neurological rehabilitation. Further research is suggested to investigate this approach in a larger population of achalasia patients.

FURTHER INFORMATION HERE

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S |

Front. Neurol. Conference Abstract. 2015.

Background: We describe a 17 year old female who presents with a history of concussions. She complains of headaches, neck pain, sensitivity to light, blurring of vision, dizziness, fatigue, trouble concentrating, balance and spatial awareness problems, sleeping problems, enuresis, depression and anxiety.

Methods: A comprehensive neurologic examination revealed that light stimulation produced akesthesia and created a dynamic right correctasia. Decreased myotatic stretch reflexes were observed on the left side of the body. Percussion myotonia was produced bilaterally upon striking of the thenar eminence. The patient participated in a neurorehabilitation program that included-off-vertical-axis-rotation vestibular rehabilitation, times-one viewing gaze stabilization exercises, passive multi-planar proximal extremity movements, specific oculomotor rehabilitation exercises and gait rehabilitation.

Results: The combination of treatment protocols produced a profound change in the patient’s state of being. All signs and symptoms significantly reduced over a short period of time and the patient was able to return to school.

Conclusion: This case showed significant improvements as a result of the functional neurologic treatment regimen as described. The authors suggest further investigation into the mechanisms of an integrated neurorehabilitation program to patients with mild traumatic brain injuries.

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

Traster D, Brenner K |

Front. Neurol. Conference Abstract. 2015.

Background: We describe a 33 year old male nine months post-concussion. Symptoms consist of headaches, neck pain, numbness on left sided face, arm and leg, anxiety, as well as feeling overwhelmed with daily tasks.

Methods: Comprehensive neurologic examination revealed a twenty pint increase in blood pressure on the right arm compared to the left. Decreased lower left peripheral field of vision upon confrontation testing, decreased right palate, left lower facial weakness, percussion myotonia of the thumb, left pendular patella reflex as well as a right oculomotor convergence spasm. A five day neurorehabilitation program was administered consisting of a canalith repositioning maneuver, repetitive peripheral somatosensory stimulation of the left trigeminal system and left median nerve, off-vertical-axis-rotation vestibular rehabilitation, visual hemistim stimulation, interactive metronome, oculomotor rehabilitation as well as breathing exercises.

Results: Patient experience improvements in headaches, neck pain, energy level, cognition as well as numbness sensations. Blood pressure was even and normal bilaterally.

Conclusion: The authors suggest further research into multimodal neurorehabilitation in the management of post-concussion syndrome.

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 49 year-old female who presents with a more than twenty year history of progressive hereditary spastic paraplegia and symptoms of anxiety, mental fatigue, exhaustion, depression, nausea, dizziness, food sensitivities, and balance problems.

Methods: Comprehensive neurologic examination demonstrated a slowness of speech, freezing and spastic gait. Computerized dynamic posturography testing showed a stability score of 39.7% on a non-perturbed surface with neutral head position and eyes open. The patient participated in a five day neurorehabilitation program that included repetitive peripheral somatosensory stimulation to maxillary and mandibular distributions of the right trigeminal system and specific oculomotor rehabilitation exercises.

Results: The patient reported improvements in limb spasticity, irritability, anxiety, fatigue and the ability to converse and concentrate. A stability score of 71.7% in a non-perturbed neutral position with eyes open was recorded.

Conclusion: Due to improvements observed, the authors suggest further research into multimodal neurolorehabilitation approaches toward spastic paraplegia.

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR and Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 11 year-old male who presents with a history of vasovagal syncope. Accompanied symptoms include dizziness, nausea, headaches, depression, anxiety, photophobia, and hyperacusis.

Methods: Comprehensive neurological examination revealed positive Rhomberg’s test to the left. The patient demonstrated a decreased left patella reflex and hyperacusis on right. The patient participated in a ten day neurorehabilitation program that included a canalith repositioning maneuver, off-vertical-axis-rotation vestibular rehabilitation, specific oculomotor rehabilitation exercises, passive complex figure eight movements of the upper extremity and visual hemifield stimulation.

Results: A significant improvement in balance, headache, dizziness, photophobia, hyperacusis and anxiety was recorded.

Conclusion: The patient saw significant improvements following a multimodal neurorehabilitation regimen. Further investigation into an integrative neurorehabilitation program for the management of post-concussion syndrome is recommended.

Significant Improvement in Severe Anxiety of 20 years Duration following Conservative Neurologic Rehabilitation program: A Case Study

George Michalopoulos, Matthew Imber and Christie Drzewiecki | Illinois Neuro and Physical Rehab, United States | Front. Neurol. Conference Abstract. 2016.

Background: A 39 year-old-female presented to the functional neurology clinic with complaints of extreme anxiety that she had been experiencing for 20 years. The anxiety caused headaches, significant stress, internal tremors, lack of concentration and hair loss. The patient reported it was difficult to function in her daily life often losing interest in things that used to be enjoyable and experiencing bouts of depression, nausea, and weight-loss.

Methods: A neurological examination revealed a hypertropia and ptosis of the left eye. She displayed a left nasolabial fold softening and weakness in the left posterior canal. She had hypometric saccades up and and to the right. Saccadic intrusions during horizontal pursuits were present. Rapid alternating movements were decreased on the right. Heel-to-shin was dysmetric on the right. Point localization was decreased on the right. During gait, she displayed a decreased left arm awing and right posterior sway. Velocity storage was dampened on the right side. The patient was diagnosed with a functional deficit of the right cerebellum and left cortex. A treatment plan was implemented that included oxygen therapy, right complex movements on the upper and lower extremities in counter phase, vibration therapy, gaze stability, repetitive peripheral somatosensory stimulation of trigeminal nerve bilaterally/right median nerve, and parasympathetic activation.

Results: The patient reported significant improvement in her anxiety levels allowing other symptoms experienced to be minimized. She also reported a decrease in headache and an increase in her ability to relax which began immediately after the initial treatment. She was given at-home therapies to perform which helped to significantly maintain the decrease in anxiety. Objective indicators include an improvement in horizontal pursuits, increased velocity storage on the right

Conclusion: We present a case of a patient with severe chronic anxiety treated with a multi-modal brain-based treatment approach. The patient experienced a significant decrease in anxiety levels within 12 visits. Further investigation is necessary to determine additional interventions that maybe utilized for treatment of chronic anxiety.

FURTHER INFORMATION HERE

ATAXIA IMPROVED THROUGH APPLICATION OF MULTIMODAL NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S, Albertin D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 20 year-old male who presents with a twelve year history of progressive ataxia. Symptoms include poor balance and coordination, poor gross and fine motor skills, stiffness, fatigue and inability to walk without assistance.

Methods: Ataxia was confirmed by neurologic examination. Aberrant saccades, pursuits, and optokinetic responses were noted. Square wave jerks were present on left gaze fixation. A right beating nystagmus was present on right gaze fixation. Decreased joint position sense and sensation to pinwheel was present in the lower extremity bilaterally. Patellar myotatic stretch reflexes were plus three bilaterally. The patient participated in an in house neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, passive multi-planar movements of proximal joints, specific oculomotor rehabilitation, times-one viewing gaze stabilization exercises, cross-crawl exercises and gait rehabilitation.

Results: The combination of treatment protocols produced profound changes in the patient’s state of being. Symptoms associated with the ataxia were dramatically reduced and the patient has been able to walk without assistance as a result of this intervention.

Conclusion: This case showed significant improvements after administration of the multimodal neurorehabilitation regimen described. The authors suggest further investigation into vestibular rehabilitation mechanisms and brain-based approaches to patient treatments with ataxic syndromes.

FUNCTIONAL IMPROVEMENTS IN A PATIENT WITH TRAUMATIC BRAIN INJURY AND DYSTONIA FOLLOWING INTEGRATED NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 15 year-old male who presents with a previous diagnosis of severe traumatic brain injury. The patient experiences difficulty maintaining upright posture, involuntary athetoid and writhing movements, subsequent seizures, ataxia and dystonia.

Methods: The patient demonstrated dystonic posturing, a right hypertropia, inability to eccentrically hold gaze, decreased gain in vertical pursuits, decreased velocity of vertical saccades, and absent optokinetic nystagmus. All aberrant eye movements were confirmed by videonystagmography. The patient participated in a six day rehabilitation program that included off-vertical-axis-rotations as well as oculomotor rehabilitation.

Results: The patient experienced an increase gain of vertical pursuit, increased velocity of horizontal and vertical saccadic eye movements as well as a normalization of optokinetic nystagmus during visual optokinetic stimulus. There was also a significant decrease in dystonic posturing and an improvement in balance.

Conclusion: This patient demonstrated marked improvement function following a treatment regimen utilizing vestibular stimulation and brain-based rehabilitation strategies. The results of this case suggest the necessity of further research into the effects of an integrated neurorehabilitation approach following traumatic brain injuries.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Methods: Comprehensive Assessment of Postural Systems testing demonstrated perturbed surface balance stability scores of 78.8% with eyes closed and head neutral, a 73.8% with head right, 73.2% with head left, 69.0% with head flexed, and 30.8% with head extended. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation and oculomotor rehabilitation strategies.

Results: The patient experienced dramatic improvements in stability as a result from this treatment. Upon re-examination of perturbed balance testing with eyes closed the patient scored a 98.6% with head neutral, a 83.8% with head right, 82.0% with head left, 80.6% with head flexed, and 69.8% with head extended. The combination of treatment protocols drastically reduced all signs and symptoms over a short period of time and the patient was able to re-enter his workplace.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

68-YEAR-OLD FEMALE WITH APALLESTHESIA IMPROVED THROUGH BRAIN-BASED REHABILITATION: A CASE STUDY

Traster D | Journal of Functional Neurology Rehabilitation and Ergonomics. 2014.

Objective: The purpose of this study is to illustrate an example of utilizing chiropractic care in concert with other brain-based rehabilitation therapies to effectively manage a patient with persistent symptoms following a motor vehicle accident.

Clinical Features: A 68 year old female patient presented to the clinic with a two year history of complete vibration loss in both legs following a motor vehicle accident. The clinical impression was that of a traumatic brain injury presenting as a centrally maintained vestibulopathy.

Intervention and Outcomes: Interventions utilized spinal and extra-spinal manipulations, gaze stabilization exercises, earth-vertical axis rotations, multi-planar movements of the right arm, and breathing exercises. The patient regained vibration in both legs and experienced such significant improvements in regards to her gait and balance that she was able to begin exercising at a fitness center for the first time in over fifteen years.

Conclusion: This case suggests that chiropractic care in conjunction with other brain-based exercises can be an effective, conservative treatment for patients with persistent neurological deficits following a traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S. | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Background: 51 year old female presents with a three year history severe vertigo, head pain and balance and gait problems post repetitive concussions.

Methods: Upon comprehensive neurological examination, patient presents with a right hypertropia and left head tilt. A significant right convergence spasm is evident on all ocular movements. Brisk and spill-over myotatic reflexes were observed on the right as well as a reversed tricep reflex on the right. Gait examination revealed severe left lateropulsion with a decrease in right arm swing. The patient participated in a five day neurorehabilitation program consisting of a right horizontal canal barbque roll repositioning maneuver, bilateral tongue electrical stimulation and times 0 viewing gaze stabilization exercises.

Results: As a result of this neurorehabiliation strategy, the patient no longer experienced any vertigo, head pain or balance and gait problems. All examination findings normalized.

Conclusion: This case showed significant improvements after administration of a multimodal neurorehabilitation regimen. The authors suggest further investigation into comprehensive neurorehabiliation programs with mild traumatic brain injuries.

ATAXIA IMPROVED THROUGH APPLICATION OF MULTIMODAL NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S, Albertin D | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: Due to improvements observed, the authors suggest further research into multimodal neurolorehabilitation approaches toward spastic paraplegia.

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 20 year-old female who presents with a previous history of multiple concussions. Symptoms include headaches, visual disturbances, nausea, and decrease stability in stance and gait.

Methods: During initial Comprehensive Assessment of Postural Systems testing on a perturbed surface and her eyes closed the patient scored a 58.6% with head neutral, a 66.6% with head right, 59.3% with head left, 74.9% with head flexed, and 62.5% with head extended. The patient also had a decreased left arm swing during gait and a positive Myerson’s/glabellar sign. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation and specific oculomotor rehabilitation exercises.

Results: Upon re-examination of perturbed balance testing with eyes closed the patient scored a 83.0% with head neutral, a 83.3% with head right, 80.7% with head left, 82.7% with head flexed, and 74.8% with head extended. The patient reported a decrease in headache duration and frequency and there was complete resolution of Myerson’s/glabellar sign and return of left arm swing during gait.

Conclusion: The results of this case suggest the necessity of further research into the use of multimodal neurorehabilitation in the management of mild traumatic brain injury.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 65 year-old female who presents with a history of unremitting arm pain, abdominal pain, head pain, incontinence, dizziness, numbness bilaterally in distal lower extremities, dysphagia, depression, frequent lacrimation, photosensitivity, sensitivity to smell and touch, and fatigability.

Methods: Upon a comprehensive neurological examination, increases in jugular pulses, hypersensitivity to smell, touch and sound were observed. The oculomotor examination revealed gaze instability to eccentric targets all directions, saccadic intrusions of smooth pursuits and hypometric saccades. The patient participated in a five day neurorehabilitation program consisting of specific oculomotor rehabilitation as well as off-vertical-axis-rotation vestibular rehabilitation.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

Conclusion: A multimodal neurorehabilitation approach produced significant improvements in a patient with dysautonomia. The authors suggest further investigation into vestibular rehabilitation mechanisms and oculomotor rehabilitation to patient treatments with dysautonomia.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe an 18 year-old male who presents with headaches, dizziness, brain fog and nausea following multiple mild traumatic brain injuries sustained during athletics. Methods: Comprehensive neurologic examination demonstrated a Myerson’s/glabella sign, and a grade 2 hypomimia on the UPDRS scale. During oculomotor examination the patient had marked instability in eccentric gaze holding in all planes, bilateral saccadic pursuits horizontally, hypometric saccades in all planes, and minimal horizontal visual optokinetic nystagmus responses. The patient participated in a five day vestibular rehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, gaze stabilization exercises and repetitive peripheral somatosensory stimulation to ophthalmic, maxillary and mandibular distributions of the trigeminal nerve bilaterally.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a female in her 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness, and disorientation.

Methods: Comprehensive neurologic examination revealed a tremor of the right hand and left hemi-facial spasm. Saccadic velocity was decreased in all directions. While performing ten rapid movements of the index finger to thumb, the left hand’s velocity was slow. The patient participated in a five day vestibular rehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, times-one viewing gaze stabilization exercises, repetitive peripheral somatosensory stimulation of the left trigeminal system and specific oculomotor rehabilitation strategies.

Results: The combination of treatment protocols drastically reduced all signs and symptoms over a short period of time and the patient was able to re-enter her workplace as a result of this intervention.

Conclusion: Significant improvements as a result of a multimodal neurorehabilitation regimen were produced. The authors suggest further investigation into comprehensive neurorehabilitation approaches to patient treatments with mild traumatic brain injuries.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 17 year-old male who presents with a five year history of concussions. Symptoms include headaches, light and sound sensitivity, fogginess, lightheadedness, trouble concentrating and reading, memory difficulties, fatigue, nausea and decreased appetite associated with weight loss.

Methods: Comprehensive neurologic examination demonstrates a downbeat nystagmus when visual fixation was eliminated. Comprehensive Assessment of Postural Systems (CAPS) testing during perturbed surface, eyes closed, head in neutral parameters, revealed a 59.3% stability score. The patient participated in a neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, specific neurorehabilitation exercises, times-one viewing gaze stabilization exercises, somato-sensory evoked potential activation of the left trigeminal system, breathing exercises and passive, multi-planar movements of right proximal extremities.

Results: The combination of treatment protocols produced profound changes to all signs and symptoms associated with the mild traumatic brain injury. Follow up CAPS results during perturbed surface, eyes closed, head in neutral parameters, revealed a 74.9% stability score and a return to exercise was achieved.

Conclusion: This case showed significant improvements after administration of a multimodal neurorehabilitation regimen. The authors suggest further investigation into vestibular rehabilitation mechanisms and brain-based approaches to patient treatments with mild traumatic brain injuries.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IN PATIENT WITH SPASTIC CEREBRAL PALSY

Carrick FR, Traster D, Sass B, Sass C, Druckman E, Brindisi L | Front. Neurol. Conference Abstract. 2015.

Background: A 22 year old patient presents with quadriplegic spastic cerebral palsy.

Methods: Comprehensive neurologic examination reveals right saccadic hypermetria upon saccadic testing, eso-deviation of the left eye, spastic paresis of all the extremities, and neostriatal posturing of the right hand. Deficits in eccentric gaze holding, pursuit eye movements, and optokinetic nystagmus were noted during the examination. A treatment approach involving oculomotor rehabilitation, visual hemifield stimulation, interactive metronome therapy, passive musculature stretches, aquatic therapy, peripheral somatosensory stimulation, and vestibular rehabilitation was administered.

Results: After five days of treatment, the patient saw significant improvements in speech articulation and comprehension, finger dexterity, focus and concentration, eating ability, as well as increased self- confidence.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of cerebral palsy.

COMPLEX REGIONAL PAIN SYNDROME IMPROVES AS A RESULT OF MULTIMODAL NEUROREHABILITATION

Traster D, Brenner K. | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 16 year old boy who presents two years post-concussion with a chief complaint of severe right-sided pain in his face and body. His right face, torso and extremities would swell multiple times a day sometimes resulting in his right side of his body being three times bigger than the left side of his body.

Methods: Comprehensive neurologic examination reveals a right ptosis with a right esotropia. A right convergence spasm is noted on convergence testing. Finger to nose testing reveals dysmetria on the right hand and a right parietal drift when targeting with the left hand. Gait examination demonstrates a decrease left arm swing with right Lateropulsion. Vibration sensation is decreased on the right side of the body compared to the left. There is aberrant two-point localization on the right side of the body and rib excursion is half of an inch. The patient participated in an eight day neurorehabilitation program consisting of canalith repositioning maneuvers, spinal and extra-spinal manipulations, off-vertical-axis-rotation vestibular rehabilitation, oculomotor rehabilitation, repetitive peripheral somatosensory stimulation of the tongue bilaterally, interactive metronome and breathing exercises.

Results: A significant improvement in right-sided pain and swelling was attained as a result of this intervention.

Conclusion: The authors suggest further research into multimodal neurorehabilitation in the management of complex regional pain syndrome.

MULTIMODAL NEUROREHABILITATION IN YOUNG BOY WITH COMPLEX REGIONAL PAIN SYNDROME

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 12 year-old male who presents with severe pain and an inability to tolerate light touch. A three year history of severe, progressing headaches, and head pain which has progressed down his back and shoulders was reported. The patient also presented with fatigue, light sensitivity and decreased appetite.

Methods: A diagnosis of complex regional pain syndrome with associated dysautonomia was confirmed by neurologic examination. Aberrant vertical eye movements were observed and a right beating nystagmus was present during eccentric gaze fixation and confirmed on videonystagmography. This nystagmus matched the frequency of the patient’s midline stereotopies in his hands. Rib excursion measured 0.5 inches and a posterior suboccipital hemangioma was noted. The patient participated in an in house neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation and oculomotor rehabilitation strategies.

Results: The combination of treatment protocols produced a profound change in the patient’s state of being. Pain and ability to tolerate touch significantly reduced over a short period of time and the patient was able to return to school and athletics.

Conclusion: This case of complex regional pain syndrome showed significant improvements beyond traditional applications after administration a multimodal neurorehabilitation regimen as described. The authors suggest further investigation into the mechanisms of the vestibular rehabilitation and oculomotor rehabilitation in regards to complex regional pain syndrome.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Results: Patient experience improvements in headaches, neck pain, energy level, cognition as well as numbness sensations. Blood pressure was even and normal bilaterally.

Conclusion: The authors suggest further research into multimodal neurorehabilitation in the management of post-concussion syndrome.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

IMPROVEMENTS IN A PATIENT WITH MILD TRAUMATIC BRAIN INJURY AND DYSLEXIA FOLLOWING MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Frontiers Neurology Conference Abstract. 2015.

Background: We describe a 60 year-old male who presented to a chiropractic neurology clinic with a history of mild traumatic brain injury. The patient experienced severe dyslexia, migraines, photophobia, hyperacusis, lack of steadiness, autonomic changes and right sided hypertonicity of musculature.

Methods: Upon comprehensive neurologic examination the patient demonstrated bilaterally non-responsive pupils upon direct light reflex, absence of adduction on left eye upon convergence testing, absent visual optokinetic nystagmus in all directions, and inability to read due to oculomotor deficits. The patient participated in a five day program of neurorehabilitation involving specific oculomotor therapy as well as off-vertical-axis-rotation therapy.

Results: The patient experienced a normalization of visual optokinetic nystagmus responses. The patient improved reading comprehension as a result of improved version and vergence integrity.

Conclusion: Integrated neurorehabilitation utilizing oculomotor, vestibular and physical rehabilitation produced significant improvements in a patient with dyslexia. The authors suggest further investigation into neurorehabilitation with dyslexia.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L Goodman Z | Front. Neurol. Conference Abstract. 2015.

Background: A 20 year old female soccer player presents with a chief complaint of vertigo, headaches, and nausea. The patient had a history multiple head traumas with reported concussions on three separate occasions

Methods: Neurological evaluation revealed akathisia and right square wave jerks in the horizontal plane. The patient had involuntary facial twitches as well as decreased right arm swing with translation across trunk during dual tasking and grade 2 finger pincer task on the right. The patient also had a difficulty balancing on a perturbed surface with her eyes closed and her neutral head. A management plan consisted of canalith repositioning maneuvers, oculomotor rehabilitation, off-vertical-axis-rotation and repetitive peripheral somatosensory stimulation.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

IMPROVEMENTS IN MILD TRAUMATIC BRAIN INJURY THROUGH MULTIMODAL NEUROREHABILITATION

Carrick FR and Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 25 year-old male who presents post-concussion with symptoms of nausea, dizziness, headaches, and loss of appetite.

Methods: Comprehensive neurologic examination the demonstrated an accommodation spasm, decreased vertical optokinetic nystagmus, blepharospasm, decreased right arm swing during gait testing. The patient participated in a five day neurorehabilitation program that included off-vertical –axis-rotation vestibular rehabilitation and specific oculomotor rehabilitation exercises.

Results: Significant improvements were seen in nausea, headaches, dizziness and appetite.

Conclusion: A multifaceted neurorehabiliation approach utilizing vestibular rehabilitation and oculomotor rehabilitation produced significant improvements in a patient with post-concussion syndrome. The results of this case suggest the necessity of further research into multimodal neurorehabilitation strategies in the management of post-concussion syndrome.

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S. | Front. Neurol. Conference Abstract. 2015.

Background: We describe a female in her 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness, and disorientation.

INTEGRATIVE NEUROREHABILITATION IMPROVES POST-CONCUSSION SYNDROME

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 26 year-old male who presents with a history of multiple concussions. Symptoms consist of head pressure, headaches, nausea and dizziness.

Methods: Comprehensive neurological evaluation revealed a left hyperopia, downbeat nystagmus, global decrease in muscles strength. Oculomotor examination revealed blepharospasm, hypometric saccades and a decrease gain in visual optokinetic nystagmus responses. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation and specific oculomotor rehabilitation exercises.

Results: The patient had significant improvement of head pressure and complete resolution of nausea and headaches.

Conclusion: A multimodal neurorehabiliation program utilizing oculomotor and vestibular rehabilitation produced significant improvements in a patient with post-concussive syndrome. The authors suggest further investigation into vestibular rehabilitation and oculomotor rehabilitation in regards to post-concussive syndrome.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

FUNCTIONAL IMPROVEMENTS IN A PATIENT WITH TRAUMATIC BRAIN INJURY AND DYSTONIA FOLLOWING INTEGRATED NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Results: Patient experience improvements in headaches, neck pain, energy level, cognition as well as numbness sensations. Blood pressure was even and normal bilaterally.

Conclusion: The authors suggest further research into multimodal neurorehabilitation in the management of post-concussion syndrome.

MULTIMODAL NEUROREHABILITATION IN THE TREATMENT OF MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S. | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his mid 20s who presents with a history of multiple concussions resulting in headaches, loss of consciousness and speech difficulties.

Methods: Comprehensive neurologic examination revealed mitotic pupils bilaterally, hypometric saccades in all directions, saccadic pursuits in all directions and absent optokinetic responses. Bilateral complexus myospasm and left sided hypotonia was noted. Three hesitations were present when performing ten rapid movements of the right index finger to thumb. The patient participated in a five day comprehensive neurorehabilitation program that included off-vertical-axis vestibular rehabilitation paired with specific oculomotor rehabilitation strategies.

Results: The combination of treatment protocols produced a significant reduction of all signs and symptoms over a short period of time. Previously absent optokinetic responses were completely restored, and the patient was able to return to work, symptom free, as a result of this intervention.

Conclusion: This case showed significant improvements as a result of an integrated neurorehabilitation regimen as described. The authors suggest further investigation into the mechanisms of the vestibular rehabilitation and brain-based approaches to patient treatments with mild traumatic brain injuries.

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S, Barton D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history of multiple concussions resulting in bilateral headaches, visual disturbances, dizziness and fatigue.

Methods: Comprehensive neurologic examination revealed saccadic intrusions within all direction of pursuits. Horizontal saccades were slow with glissades. Optokinetic responses had a decreased gain in all directions. A left beating nystagmus was revealed when fixation was eliminated. Comprehensive Assessment of Postural Systems (CAPS) testing during perturbed surface, eyes closed, head in extension parameters, revealed a 15.5% stability score. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, times-one viewing gaze stabilization exercises, somatosensory evoked potential stimulation of the left trigeminal system, oculomotor rehabilitation strategies and spinal manipulations.

Results: The combination of treatment protocols allowed the patient to return to his work place symptom free. Follow up CAPS results during perturbed surface, eyes closed, head in extension parameters, revealed a 53.6 stability score.

Conclusion: This case showed significant improvements as a result of the multimodal neurorehabilitation regimen described. The authors suggest further investigation into vestibular rehabilitation and brain-based therapies to patient treatments with mild traumatic brain injuries.

NEUROREHABILITATION IMPROVES PATIENT WITH REPETITIVE TRAUMATIC BRAIN INJURIES

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 27 year old female who presents with a seven year history of concussions. She complains of headaches, fatigue, memory and concentration problems, nausea, depression and speech difficulties.

Methods: A diagnosis of a centrally maintained vestibulopathy secondary to a mild traumatic brain injury was confirmed by examination. Aberrant gaze fixation, saccades and pursuits were observed and confirmed by videonystagmography. A negative center of pressure with a rightward bias was recorded upon a Comprehensive Assessment of Postural Systems (CAPS) unit. The patient participated in a neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, somato-sensory evoked potential stimulation of the right trigeminal system, times-one viewing gaze stabilization exercises, specific oculomotor rehabilitation therapies and application of low-level laser over the suboccipital musculature.

Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.

Conclusion: This case of a mild traumatic brain injury showed significant improvements as a result of a multimodal neurorehabilitation regimen as described. The authors suggest further investigation into the mechanisms of the vestibular rehabilitation and brain-based approaches to patient treatment with mild traumatic brain injuries.

MULTIMODAL NON-ACUTE NEUROREHABILITATION IN THE TREATMENT OF SEVERE TRAUMATIC BRAIN INJURY

Traster D, Williams T, Esposito S | Front. Neurol. Conference Abstract. 2016.

Background: A 29 year old female presented with a left sided hyperkinetic movement disorder as a result of a fall off a cliff at 6 years of age. This fractured her skull in over 20 places and resulted in her enduring a drug induced coma and brain swelling.

Methods: A thorough neurological exam revealed left arm dystonia with choreiform movements at rest as well as left leg spasticity. When attempting movement of her extremities, her left side mirrored the right so she was unable to move the right side of her body without the left side moving with it. Her exam also revealed positive myersons/glebella sign, hyper-reflexive myotatic reflexes on the left side and clonus on the left leg. Her right side displayed facial twitches accompanied by “the other” babinski sign of paradoxical eyebrow raising. She experienced lightheadedness when changing position from seated to standing. Sensory exam revealed graphesthesia bilaterally and the inability to feel light touch on the left arm unless accompanied by simultaneous visualization of the left arm while it was being touched. Oculomotor exam revealed left eye convergence failure, saccadic intrusions on attempted pursuits bilaterally, worse to right than to the left, and downbeat nystagmus was noted without fixation. The patient’s treatment included leftward rotations in a chair. She performed mirror therapy exercises by watching her right side extremity movement in a mirror designed to make it appear as if she were watching her left extremity movement. Additionally, she observed her left fingers and arm as they were independently stimulated by vibration. Lastly, her treatment included micro-saccade exercises to visible targets and memorized targets, as well as gaze stabilization exercises in horizontal and vertical planes to targets aligned in a cross pattern.

Results: The patient was able to move her right side of her body independently from any left sided movement, experiencing a total resolution to her prior mirroring. Improvements were also noted by a decrease in chorea and dystonia of her left arm. However, she still was unable to functionally use her left hand due to the remaining degree of dystonia.

Conclusion: This case shows that even two decades post injury, improvements can be experienced. However due to the ablative nature of the injury full function was not restored. More research should be done on multimodal brain based rehab therapy for patients with traumatic brain injury both in the acute and post-acute phases of traumatic brain injury.

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Background: 51 year old female presents with a three year history severe vertigo, head pain and balance and gait problems post repetitive concussions.

Results: As a result of this neurorehabiliation strategy, the patient no longer experienced any vertigo, head pain or balance and gait problems. All examination findings normalized.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L, Goodman Z | Front. Neurol. Conference Abstract. 2015.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: The results of this case suggest the necessity of further research into the use of multimodal neurorehabilitation in the management of mild traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IMPROVES VERTIGO AND DIPLOPIA

Carrick FR, Traster D, Sass B, Sass C, Funk A and Acevedo J | Front. Neurol. Conference Abstract. 2015.

Background: A 13 year old male presents with the chief complaint of diplopia and vertigo after sustaining two closed head injuries during athletics.

Methods: A thorough neurological examination revealed a right beating nystagmus in the dark, left sided hypertonic musculature, decreased left arm swing during gait, and spilling of reflexes on his left side. Upon initial diagnostic testing, only nineteen out of one-hundred saccades registered on the saccadometer testing. A management plan involving oculomotor rehabilitation, repetitive peripheral somatosensory stimulation, mirror therapy and off-vertical-axis-rotation vestibular rehabilitation was performed.

Results: After five days of treatment, the patient reported a complete resolution of diplopia and vertigo. The patient had significant improvements in clinical markers of posturography and recorded a full hundred saccades during follow-up saccadometer testing.

Conclusions: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the treatment of mild traumatic brain injuries.

Resolution of professional hockey players’s concussion
symptomatology allowing him to return to play following a
brain-based therapy approach: a case study

George Michalopoulos^1*, Missy Holas², Michael Drzewiecki¹ and Christie Drzewiecki¹ | ¹ Illinois Neuro and Physical Rehab, United States, ² Core Elite, United States | Front. Neurol. Conference Abstract. 2016.

Background: A 25-year-old male hockey player presented to the functional neurology clinic with symptoms of a previous concussion that occurred 1 year prior. Symptoms included headache with 7/10 pain stemming from the right sub-occipital region, blurred vision, light sensitivity, fluctuating mood, and a significant decrease in short term memory.

Methods: A neurological examination revealed hyperesthesia of C5-C6 and V2 on the right and L4-L5, V1, V3 on the left. Vibration was diminished on the right with associated spreading distal to proximal bilaterally. Saccades in the vertical plane were subjectively challenging and caused facial grimacing. Horizontal pursuits were smooth but with associated head movement. Vertical pursuits displayed saccadic intrusions throughout. Convergence/divergence testing displayed a retropulsion activity and an increase in headache. Rapid alternating movements were slower on his right. He demonstrated an increased FRA on the left during testing of plantar reflex. Pincer test was Grade 1 on the left and Grade 2 on the right with hesitations. Toe tap was decreased bilaterally with hesitations. During gait, he displayed a decreased arm swing bilaterally, but more pronounced on his right which was maintained during dual tasking. Dual tasking caused freezing and hesitations with ambulation. The patient was diagnosed with post-concussive syndrome. A treatment plan was implemented including gaze stability exercises, nonlinear complex movements on the left upper and lower extremities, bead string exercises, oxygen therapy, and rotation therapy.

Results: The patient was seen in the office for 10 visits and given at-home therapies to perform each day. He saw significant improvements in his symptoms with complete resolution of headaches. Objective indicators in gaze stability, horizontal and vertical pursuits, horizontal and vertical saccades, and optokinetics.

Conclusions: An NHL player suffering from post-concussive symptoms experiences complete resolution of headaches and improvement in objective findings following multi-modal brain based therapy. Further investigation is needed to determine other interventions that may aid in post-concussive brain based therapy.

FURTHER INFORMATION HERE

100% Improvement of Symptoms in Post-Concussion Syndrome in a Twenty-One Year Old College Female as a Result of Neurological Rehabilitation

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: A 21-year-old female reports with symptoms as a result of four known concussions. The most debilitating symptoms are headaches, neck pain, memory difficulties, light and sound sensitivity, and dizziness.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Ten therapy sessions over a span of 10 weeks were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, cognitive therapy, neuromuscular reeducation, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: A 100% improvement was reported after the 10 treatment sessions. A 36% improvement in Trails B testing and a 15% improvement in processing speed were reported during the neurocognitive assessment after the five-day rehabilitation program.

Conclusion: The patient had complete resolution of symptoms and objective improvement in executive function. The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of post-concussion syndrome.

Five-Day Multimodal Rehabilitation For A 39 Year-Old Female With Post-Concussive Syndrome Results in a 93% Improvement in Symptoms

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: A 39-year-old female reports with symptoms as a result of a concussion two years prior. The most debilitating symptoms are dizziness, balance problems, left-sided dystonia, anxiety, light and sound sensitivity, tachicardia, and diplopia.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Three therapy sessions in five days were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, balance training, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: A 93% improvement was reported in global symptoms after the five-day rehabilitation program.

Conclusion:. The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of post-concussion syndrome.

Five-Day Multimodal Rehabilitation For A 41 Year-Old Female With Post-Concussive Syndrome Results in a 59% Improvement in Symptoms

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: A 41-year-old female reports with symptoms as a result of a concussion three years prior. The most debilitating symptoms are vertigo, blurry vision, headaches, neck pain, and concentration problems.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Three therapy sessions in five days were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, balance training, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: A 59% improvement was reported in global symptoms after the five-day rehabilitation program. A 64% improvement was seen in Trails A testing and a 47% improvement was seen in Trails B testing during the neurocognitive assessment after the five day treatment program.

Conclusion:. The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of post-concussion syndrome.

Five-Day Multimodal Rehabilitation For A 25 Year-Old Female With Post-Concussive Syndrome Results in a 68% Improvement in Symptoms

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: A 25-year-old female reports with symptoms as a result of a concussion one year prior. The most debilitating symptoms are head and back pain, dizziness, tinnitus, tremor, brain fog, and communication difficulties. She also reports a life long history of irritable bowel syndrome.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Three therapy sessions in five days were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, balance training, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: A 68% improvement was reported in global symptoms after the five-day rehabilitation program. A 36% improvement was seen in Trails A testing during the neurocognitive assessment after the five day treatment program.

Conclusion:. The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of post-concussion syndrome.

Three-Day Multimodal Rehabilitation For A 48 Year-Old Female With Post-Concussive Syndrome Results in a 68% Improvement in Symptoms

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: A 48-year-old female reports with symptoms as a result of a concussion five months prior. The most debilitating symptoms were head pain, tinnitus, light/sound sensitivity, nausea, mood swings, brain fog, and communication difficulties.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Three therapy sessions in three days were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, balance training, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: A 68% improvement was reported in global symptoms after the three-day rehabilitation program. A 35% improvement was seen in Trails A testing during the neurocognitive assessment after the three day treatment program.

Conclusion: The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of post-concussion syndrome.

CONSTIPATION IMPROVED THROUGH BRAIN-BASED REHABILITATION

Traster D | Journal of Functional Neurology Rehabilitation and Ergonomics. 2014.

Background: A 48 year old homeless female with a twenty year history of constipation and stomach pain entered into the Life University Marble Mill Clinic in Marietta, GA. The patient has taken daily laxitives for the past five years in order to have any bowl movement.

Methods: Bedside examination revealed zero bowel sounds in a span of two minutes with hyperresonant percussion over the abdomen. There was no palate elevation bilaterally upon phonation. Saccades were hypometric and slow to the left. While performing ten rapid movements of the index finger to thumb, there was decreased amplitude immediately with five hesitation on the left. The patient was prescribed brain-based rehabilitation strategies which consisted of microsaccades to the left with pursuits to the right, gargling exercises, and abdominal myofascial work.

Results: The combination of treatments drastically improved the patients signs and symptoms over a two week period. The patient was able to have daily bowel movements whitout the use of any laxitives as a direct result of this intervention.

Conclusion: Significant improvement as a result of a functional neurologic treatment regimen were produced. This author suggest further investigation into brain-based rehabilitation approaches to patient treatments with digestive complaints.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

NEUROREHABILITATION IMPROVES PATIENT WITH REPITIVE TRAUMATIC BRAIN INJURIES

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: Due to improvements observed, the authors suggest further research into multimodal neurolorehabilitation approaches toward spastic paraplegia.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: A significant improvement in balance, headache, dizziness, photophobia, hyperacusis and anxiety was recorded.

Resolution of postural orthostatic tachycardic syndrome following a brain-based therapy approach

George Michalopoulos¹ and Derek Barton² | ¹ Illinois Neuro and Physical Rehabilitation, United States, ² Carrick Institute, United States | Front. Neurol. Conference Abstract. 2016.

Background: A 14-year-old female patient presented to a functional neurology clinic with a prior diagnosis of postural orthostatic tachycardic syndrome and complaints of poor sleep, dizziness with positional changes, and head pain all occurring after the Gardasil series of vaccinations. The patient reported it was difficult to function in her daily life, school life, and she experienced difficulty interacting in social situations.

Methods: A neurological examination revealed hyperesthesia of C5-C6 and V3 on the left and L3-L5 on the right. Vibration was diminished in her left upper extremity. She had saccadic intrusions during pursuits in the horizontal plane and convergence myospasm. The patient was diagnosed with functional deficit of the right cerebellum and left cortex. A treatment plan was implemented that included gaze stability exercises, optokinetic stimulation, breathing exercises, oxygen therapy, repetitive peripheral somatosensory stimulation of the trigeminal nerve bilaterally, parasympathetic activation, and nonlinear complex movements of the extremities.

Results: The patient completed an intensive treatment program where she was seen two times per day for four days. She saw improvements in her ability to sleep during this period. Two weeks after treatment the patient had a repeat tilt-table test performed and the results came back as within normal limits. The patient reports she is now able to play soccer competitively again.

Conclusion: We present a case of a patient diagnosed with postural orthostatic tachycardic syndrome treated with a multi-modal brain-based treatment approach. The patient was able to achieve normal cardiac testing after her treatment program. Further investigation is necessary to look at therapeutic interventions with dysautonomia.

FURTHER INFORMATION HERE

VERTIGO IMPROVED WITH MULTIMODAL NEUROREHABILITATION PROGRAM

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 60’s who presents with a three year history of vertigo. Episodes of three to eight hour durations would produce dizziness, disorientation, tinnitus, as well as memory and cognitive difficulties.

Methods: A centrally maintained vertigo was confirmed through neurological examination. The patient was found to have a 10hz tremor on the right arm with decrease right arm swing during gait. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation, specific oculomotor rehabilitation strategies, times-one viewing gaze stabilization exercises, extra-spinal manipulations and gait rehabilitation.

Results: The combination of treatment protocols produced profound changes in the patient’s state of being. Patient reported that this intervention eliminated the dizziness and unsteadiness for the first time since its onset.

Conclusion: This case of vertigo showed significant improvements after administration of an integrated neurorehabilitation regimen as described. The authors suggest further investigation into vestibular rehabilitation mechanisms and brain-based approaches to patient treatments with vertigo.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L, Goodman Z | Front. Neurol. Conference Abstract. 2015.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L, Goodman Z | Front. Neurol. Conference Abstract. 2015.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

IMPROVEMENTS IN MILD TRAUMATIC BRAIN INJURY THROUGH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 25 year-old male who presents post-concussion with symptoms of nausea, dizziness, headaches, and loss of appetite.

Results: Significant improvements were seen in nausea, headaches, dizziness and appetite.

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a female in her 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness, and disorientation.

INTEGRATIVE NEUROREHABILITATION IMPROVES POST-CONCUSSION SYNDROME

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 26 year-old male who presents with a history of multiple concussions. Symptoms consist of head pressure, headaches, nausea and dizziness.

Results: The patient had significant improvement of head pressure and complete resolution of nausea and headaches.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S, Barton D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history of multiple concussions resulting in bilateral headaches, visual disturbances, dizziness and fatigue.

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Background: 51 year old female presents with a three year history severe vertigo, head pain and balance and gait problems post repetitive concussions.

Results: As a result of this neurorehabiliation strategy, the patient no longer experienced any vertigo, head pain or balance and gait problems. All examination findings normalized.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: Due to improvements observed, the authors suggest further research into multimodal neurolorehabilitation approaches toward spastic paraplegia.

MULTIMODAL NEUROREHABILITATION IMPROVES VERTIGO AND DIPLOPIA

Carrick FR, Traster D, Sass B, Sass C, Funk A, Acevedo J | Front. Neurol. Conference Abstract. 2015.

Background: A 13 year old male presents with the chief complaint of diplopia and vertigo after sustaining two closed head injuries during athletics.

Conclusions: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the treatment of mild traumatic brain injuries.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: A significant improvement in balance, headache, dizziness, photophobia, hyperacusis and anxiety was recorded.

ORTHOSTATIC INTOLERANCE IMPROVED WITH MULTIMODAL BRAIN-BASED REHABILITATION IN PROFESSIONAL HOCKEY PLAYER

Sockander L, Traster D, Behrendt B, Brenner K | Front. Neurol. Conference Abstract. 2016.

Background: A professional hockey player presented to the clinic with complaints of lightheadedness associated with decreased stability upon elevation. Symptoms have been occurring over the last 2-3 years and have increased with recent head trauma.

Methods: A through neurologic examination accompanied by pre/post diagnostic assessments utilizing computerized dynamic posturography (CDP), videonystagmography (VNG), saccadometry (SAC) and video head impulse testing (VHIT) was performed. Neurological examination revealed an increase of heart rate of 36 points from laying to standing which correlated with the perception of lightheadedness. The patient performed seven therapy sessions in four days which included canal repositioning maneuvers (CRP), vestibulo-ocular rehabilitation, somatosensory evoked potential (SSEP) stimulation, non-invasive vagal nerve stimulation, oculomotor therapy, myofascial work, tilt table therapy with active muscle recruitment and spinal and extra-spinal manipulations.

Results: As a result of this therapeutic intervention the patient no longer experienced any lightheadedness. The patient was 66% stable on computerized posturography with eye closed, perturbed surface with his head in extension where as he fell immediately in this position pre therapy.

Conclusion: This outcome supports the notion of multimodal brain-based rehabilitation strategies for patients with dysautonomia. The authors support further research into a multimodal brain-based approach for dysautonomia.

IMPROVEMENTS OF MEMORY LOSS AND DIGESTION FOLLOWING MULTIMODAL NEUROREHABILITATION STRATEGIES

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 43 year-old female who presents with a history of short-term memory loss, and complains of food sensitivities such as gluten sensitivity. The patient also describes severe dizziness, photophobia, and hyperacusis.

Methods: During examination the patient demonstrated decreased right arm swing during gait and positive pull test. Oculomotor examination revealed saccadic intrusions of left gaze holding, unconjugated pursuit following responses where the left eye was 23% slower than the right, and decrease in gain of visual optokinetic responses in all directions. The patient participated in a five day neurorehabilitation program involving oculomotor rehabilitation exercises as well as off-vertical-axis-rotation vestibular rehabilitation.

Results: Improvements confirmed by videonystagmography were seen with eye conjugacy as well as gaze stability. The patients memory retention and overall mood significantly improved. The patient also reported a significant improvement in her digestive capabilities.

Conclusion: The results of this case suggest the necessity of further research into the application of multimodal neurorehabilitation in regards to patients with short term memory loss and digestive problems.

UNILATERAL ARM AND LEG TREMOR IMPROVE FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass B, Sass C, Funk A, Ranvik K, Behrendt B | Front. Neurol. Conference Abstract. 2015.

Background: A 22 year old school teacher presents with the chief complaint of a mixed resting/kinetic tremor that began approximately 4 years prior in her right hand, however it has spread into her right face, arm and leg. The patient also reported a history of frequent dizziness, specifically qualifying the symptomatology as a right egocentric vertigo. She also experienced sharp headaches, localized to the vertex of the head, occurring several times daily for one to five minutes in duration. She also reported chronic and continuous exhaustion over the past 4 years.

Methods: Upon thorough neurological examination, the patient demonstrated a right hypertropia with a left head tilt accompanied by clockwise circumduction oscillation of the trunk and right leg. She demonstrated a significant right parietal drift of her right arm when extending her arms forward with her eyes closed. Smooth pursuit caused the amplitude of the tremor to increase while also evoking a sensation of nausea in the patient. Light increased the frequency and amplitude of the tremor in the right hand during ophthalmoscopy, which also revealed a right-beating nystagmus. Oculomotor rehabilitation, off-vertical-axis-rotations, repetitive peripheral somatosensory stimulation and low-level laser therapy was applied.

Results: After four days of treatment, the patient reported a complete resolution of the tremor, improvement in gait and stance, and the ability to play the piano again.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of tremor.

Resolution of Vertigo and Balance Disorder of 15 years duration with Reception Based and Brain Based Rehabilitation

George Michalopoulos^1*, Michael Drzewiecki¹, Christie Drzewiecki¹ and Matthew Imberi¹ | ¹ Illinois Neuro and Physical Rehab, United States | Front. Neurol. Conference Abstract. 2016.

Background: A 60-year-old male patient presented to the functional neurology clinic with complaints of severe vertigo occurring intermittently for the past 15 years. He experienced associated symptoms such as depression, unsteadiness, lightheadedness, changes in vision, and changes in hearing. He described the vertigo as a feeling of the room around him moving. The patient reported it was very difficult for him to function in his daily life and experienced difficulty with various activities including going to work, taking care of himself, household chores, traveling, and social interactions.

Methods: A neurological examination revealed a ptosis of the right eye and a soft nasolabial fold on the right. An action tremor was present in the right hand along with a transient head tremor in the horizontal plane. During gait, a left lateral pulsion was present. Grade 3 finger tap was present on the right and Grade 1 on the left. Romberg’s demonstrated a left posterior sway. Convergence spasm was present on the right. Saccadic intrusions present during horizontal pursuits causing the right ptosis to increase. Finger to nose was slower on the right. Point localization was decreased on the right. Computerized Posturography Results displayed profoundly reduced balance with eyes open and closed on both flat and perturbed surface. There was a significant reduction in balance with eyes closed and head turned to the right and eyes closed with head in extension. A treatment plan was implemented that included gaze stability exercises, nonlinear complex movements of the right upper and lower extremities, rotational therapy, bead string therapy, and repetitive peripheral somatosensory stimulation of the trigeminal nerve and gait protocol performed bilaterally. Results: The patient reported seeing significant improvement in vertigo, balance, and concentration immediately following the initial visit continuing to improve throughout the next two weeks. He was able to return to work with no reoccurrence of vertigo. Objective indicators in gaze holding, horizontal and vertical pursuits, horizontal and vertical saccades, and horizontal optokinetics showed considerable improvement over the course of treatment.

Conclusion: A patient with severe vertigo finds significant relief through conservative neurological rehabilitation. Further research is needed to investigate interventions involving brain-based therapy for vertigo.

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Five-Day Multimodal Rehabilitation For A 45 Year-Old Female with Mal de Debarquement Syndrome Results in an 80% Reduction of Dizziness

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: 45-year-old female who presents with a ten year history of constant dizziness as a result of mal de debarquement syndrome. Symptoms began immediately after week long cruise.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Three therapy sessions in five days were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, balance training, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: An 80% improvement in dizziness, a 21% improvement in balance, and a 36% improvement was seen in Trails B testing during the neurocognitive assessment after the five day treatment program.

Conclusion: The patient had improvements in subjective symptoms, as well as objective measurements of balance and executive function. The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of mal de debarquement syndrome.

MULTIMODAL NEUROREHABILITATION IMPROVES PATIENT WITH DEVELOPMENTAL DYSLEXIA

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 20 year old male who presents with developmental dyslexia, ADHD and visual tracking problems.

Methods: Comprehensive neurologic examination demonstrated a left yaw and left roll head positioning with a left correctasia. Decrease palate elevation bilaterally, decrease of left peripheral visual field upon confrontation testing, bilateral decrease of arm swing upon gait examination with left Lateropulsion during dual task, left percussion myotonia of the thumb and a positive Myerson’s/glabellar sign. Oculomotor examination revealed large amplitude saccadic intrusions contaminating the smooth visual pursuits in all directions. Three days of a neurorehabilitation program was administered consisting of specific oculomotor rehabilitation, off-vertical-axis-rotation vestibular rehabilitation, interactive metronome and repetitive peripheral somatosensory stimulation of the tongue bilaterally.

Results: Patient reported improvement in focus and reading ability. Initial saccadic intrusions were completely resolved during pursuit testing in all directions.

Conclusion: This case showed significant improvements in a patient with developmental dyslexia. The authors suggest further investigation concerning a multimodal neurorehabilitation strategy in the management of developmental dyslexia.

IMPROVEMENTS IN A PATIENT WITH MILD TRAUMATIC BRAIN INJURY AND DYSLEXIA FOLLOWING MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Frontiers Neurology Conference Abstract. 2015.

Results: The patient experienced a normalization of visual optokinetic nystagmus responses. The patient improved reading comprehension as a result of improved version and vergence integrity.

TREATMENT OF CERVICAL DYSTONIA THROUGH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 33 year-old female who presents with over a ten year history of cervical dystonia.

Methods: Comprehensive neurologic examination demonstrated spasticity of the right sternocleidomastoid musculature. Oculomotor examination revealed saccadic intrusions on pursuits bilaterally with, hypometric saccades to the right and a decrease in gain of the visual optokinetic nystagmus responses in all directions. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation and specific oculomotor rehabilitation exercises.

Results: The patient exhibited improvements in the frequency and intensity of her cervical dystonia.

Conclusion: This case of cervical dystonia showed improvements after administration of a multimodal neurorehabilitation program. The authors suggest further investigation into integrative neurorehabilitation approaches to the management of dystonia.

RESOLUTION OF BLEPHEROSPASM THROUGH MULTIMODAL NEUROREHABILIATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 57 year-old female who presents with reading difficulty, dizziness, nausea, anxiety, and tremors in hands bilaterally. The initiation of symptomatology began after suffering a closed head injury.

Methods: Comprehensive neurologic examination revealed bilateral blepharospasm, bilateral tremors, dysmetric point localization and paradoxical pull test reaction. The patient participated in a five day neurorehabilitation program that included off-vertical-axis-rotation vestibular rehabilitation and oculomotor rehabilitation exercises.

Results: There was a complete resolution of the blepharospasm. The patient demonstrated significant improvement in balance, gait, point localization and graphesthesia.

Conclusion: A multimodal neurorehabiliation program utilizing oculomotor and vestibular rehabilitation produced significant improvements in a patient with a blepherospam. The authors suggest further investigation into vestibular rehabilitation and oculomotor rehabilitation in regards to blepherospasm.

ANISMUS TREATED THROUGH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 60’s who presents with a four year history of severe, progressing anal pain with associated pain in the left ear and jaw. Patient reported a year before the anal pain there was bilateral numbness on the bottom of both feet which never improved. Patient also reports regular bouts of constipation which last four to five days. Hemorrhoidectomy, disimpaction, ganglion impar block, lidocaine trigger point injection, pudendal block and superior hypogastric block has been performed with no impact on anal pain. All imaging was unremarkable.

Methods: A diagnosis of anismus was confirmed by neurologic examination. Aberrant pursuits, saccades and optokinetic responses were observed along and confirmed by videonystagmography. Blepheroclonus was present during gaze stabilization. The patient participated in a neurorehabilitation program that included peripheral repetitive somatosensory stimulation of the right trigeminal system, specific oculomotor rehabilitation strategies, along with application of low-level laser over the anus.

Results: The combination of treatment protocols produced up to 40% decrease of symptoms, as reported by the patient, which was beyond any previous treatment application.

Conclusion: This case of anismus showed improvements beyond traditional applications after administration of an integrated neurorehabilitation regime. The authors suggest further investigation into the mechanisms of these brain-based approaches to patient treatment with anismus.

FUNCTIONAL IMPROVEMENTS IN A PATIENT WITH TRAUMATIC BRAIN INJURY AND DYSTONIA FOLLOWING INTEGRATED NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a female in her 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness, and disorientation.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S Barton D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history of multiple concussions resulting in bilateral headaches, visual disturbances, dizziness and fatigue.

NEUROREHABILITATION IMPROVES PATIENT WITH REPETITIVE TRAUMATIC BRAIN INJURIES

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.

ATAXIA IMPROVED THROUGH APPLICATION OF MULTIMODAL NEUROREHABILITATION APPROACH

Carrick FR, Traster DJ, Esposito S, Albertin D | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: Due to improvements observed, the authors suggest further research into multimodal neurolorehabilitation approaches toward spastic paraplegia.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

UNILATERAL ARM AND LEG TREMOR IMPROVE FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass B, Sass C, Funk A, Ranvik K, Behrendt B | Front. Neurol. Conference Abstract. 2015.

Results: After four days of treatment, the patient reported a complete resolution of the tremor, improvement in gait and stance, and the ability to play the piano again.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of tremor.

IMPROVEMENTS IN FACIAL PARALYSIS WITH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 64 year-old male who presents with a twenty-eight year history of left-sided facial paralysis.

Methods: During examination the patient demonstrated decreased pinwheel sensation on the left trigeminal system, loss of left corneal reflex, hypometric saccades rightward, and weakness on the left side of the face. The patient participated in an in-house neurorehabilitation program for five days. Treatment consisted of repetitive peripheral somatosensory stimulation to ophthalmic, maxillary and mandibular distributions of the left trigeminal nerve. Therapy also included mirror therapy and oculomotor rehabilitation.

Results: Improvements in orofascial motor control and sensation on the left side of the face with an increased corneal reflex were observed.

Conclusion: Partial resolution of facial paralysis following implementation of a multimodal neurorehabilitation program was observed. The results of this case suggest the necessity of further research into the an integrative neurorehabiliation approach to facial paralysis.

MULTIMODAL BRAIN BASED THERAPY IN THE TREATMENT OF CHRONIC EPISODIC HEADACHES

Traster D, Brodyn A, Mullin Elkins L | Front. Neurol. Conference Abstract. 2016.

Background: A middle aged woman presented to a Chiropractic Neurology clinic with the complaint of headaches beginning three years ago. Each episode of headaches would last 2 to 3 weeks without relief. Once the headache would subside, another headache would emerge within 7 days.

Methods: Videonystagmography (VNG) revealed large horizontal square wave jerks in all directions of gaze which increased in amplitude and frequency after saccades and during pursuits in all directions. There were pro-saccade errors in an anti-saccade task seven out of ten times. A decrease in vibration sense on the right in comparison to the left was noted throughout the whole body. Moderate dysmetria was seen on rapid alternating hand movements bilaterally which was more pronounced on the right. A right palatal paresis was noted. There was a deficit in graphesthesia on the right. There was decreased pin-prick sensation over all branches of the trigeminal nerve on the left and corneal reflex was decreased on the left. During Weber test sound was only reported by the patient in the right ear, however Rinne test was normal. Finger tapping was graded at 1 bilaterally while finger-to-nose test was dysmetric on the left. Gait examination revealed a right lateropulsion and decreased left arm swing that degraded during dual tasking. A multimodal brain based rehabilitation program was initiated three times a day for three consecutive days. Gaze stabilization, vestibulo ocular reflex (VOR) exercises and convergence-divergence oculomotor tasks were initiated. Electrical stimulation in the trigeminal and median nerve distributions was administered. Other treatment included interactive metronome, myofascial therapy to the neck and jaw, and off-vertical-axis rotation stimulation. The patient was released with at-home exercises including gaze stabilization, VOR exercises and exercises with an interactive metronome.

Results: Full resolution of recurrent headaches was reported at a four month follow up. Normalization occurred in deficits of graphesthesia, corneal reflex, gait abnormalities, vibration, pinwheel sense, DDK, dysmetria, finger tap, and Weber tests. Anti-saccades and palatal tone improved. Repeat VNG showed gaze, in all directions, was stabilized without the presence of square wave jerks.

Conclusion: The positive outcomes demonstrated in this case warrant further study into patient specific oculomotor function for both diagnosis and treatment of chronic episodic headaches.

IMPROVEMENTS IN A PATIENT WITH MILD TRAUMATIC BRAIN INJURY AND DYSLEXIA FOLLOWING MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Frontiers Neurology Conference Abstract. 2015.

Results: The patient experienced a normalization of visual optokinetic nystagmus responses. The patient improved reading comprehension as a result of improved version and vergence integrity.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

IMPROVEMENTS IN MILD TRAUMATIC BRAIN INJURY THROUGH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 25 year-old male who presents post-concussion with symptoms of nausea, dizziness, headaches, and loss of appetite.

Results: Significant improvements were seen in nausea, headaches, dizziness and appetite.

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a female in her 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness, and disorientation.

INTEGRATIVE NEUROREHABILITATION IMPROVES POST-CONCUSSION SYNDROME

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 26 year-old male who presents with a history of multiple concussions. Symptoms consist of head pressure, headaches, nausea and dizziness.

Results: The patient had significant improvement of head pressure and complete resolution of nausea and headaches.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Results: Patient experience improvements in headaches, neck pain, energy level, cognition as well as numbness sensations. Blood pressure was even and normal bilaterally.

Conclusion: The authors suggest further research into multimodal neurorehabilitation in the management of post-concussion syndrome.

MULTIMODAL NEUROREHABILITATION IN THE TREATMENT OF MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his mid 20s who presents with a history of multiple concussions resulting in headaches, loss of consciousness and speech difficulties.

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S, Barton D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history of multiple concussions resulting in bilateral headaches, visual disturbances, dizziness and fatigue.

NEUROREHABILITATION IMPROVES PATIENT WITH REPETITIVE TRAUMATIC BRAIN INJURIES

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

Traster D, Brenner K | Front. Neurol. Conference Abstract. 2015.

Background: 51 year old female presents with a three year history severe vertigo, head pain and balance and gait problems post repetitive concussions.

Results: As a result of this neurorehabiliation strategy, the patient no longer experienced any vertigo, head pain or balance and gait problems. All examination findings normalized.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L, Goodman Z | Front. Neurol. Conference Abstract. 2015.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: The results of this case suggest the necessity of further research into the use of multimodal neurorehabilitation in the management of mild traumatic brain injury.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: A significant improvement in balance, headache, dizziness, photophobia, hyperacusis and anxiety was recorded.

UNILATERAL ARM AND LEG TREMOR IMPROVE FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass B, Sass C, Funk A, Ranvik K, Behrendt B | Front. Neurol. Conference Abstract. 2015.

Results: After four days of treatment, the patient reported a complete resolution of the tremor, improvement in gait and stance, and the ability to play the piano again.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of tremor.

Five-Day Multimodal Rehabilitation For A 61 Year-Old Female With A Chronic Pain Syndrome Results in an 85% Improvement in Symptoms

David Traster, Kelsey Brenner, Joseph Coppus | Front. Neurol. Conference Abstract. 2019.

Background: A 61-year-old female reports with a four year history of headaches. The headaches began insidiously with no known cause.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including neurocognitive testing, dynamic posturography (CDP), videonystagmography (VNG), and quantitative electroencephalography(QEEG). Three therapy sessions in five days were performed and included therapies such as vestibular rehabilitation, visual rehabilitation, balance training, electrical stimulation of peripheral nerves, and z-score neurofeedback training.

Results: A 85% improvement was reported in global symptoms after the five-day rehabilitation program including a 100% improvement in head pain.

Conclusion:. The authors suggest continued research in a multimodal neurological rehabilitation in regards to treatment of head pain.

IMPROVEMENTS OF MEMORY LOSS AND DIGESTION FOLLOWING MULTIMODAL NEUROREHABILITATION STRATEGIES

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L, Goodman Z | Front. Neurol. Conference Abstract. 2015.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

IMPROVEMENTS IN MILD TRAUMATIC BRAIN INJURY THROUGH MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 25 year-old male who presents post-concussion with symptoms of nausea, dizziness, headaches, and loss of appetite.

Results: Significant improvements were seen in nausea, headaches, dizziness and appetite.

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a female in her 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness, and disorientation.

INTEGRATIVE NEUROREHABILITATION IMPROVES POST-CONCUSSION SYNDROME

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a 26 year-old male who presents with a history of multiple concussions. Symptoms consist of head pressure, headaches, nausea and dizziness.

Results: The patient had significant improvement of head pressure and complete resolution of nausea and headaches.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

NEUROREHABILITATION IMPROVES PATIENT WITH REPETITIVE TRAUMATIC BRAIN INJURIES

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: The patient had a complete resolution of dizziness as well as improvements in mental clarity and nausea.

Conclusion: The authors suggest further investigation into multimodal neurorehabilitaion in the management of mild traumatic brain injuries.

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

>Carrick FR, Traster D, Sass C, Sass B, Plasker J, Brindisi L, Goodman Z | Front. Neurol. Conference Abstract. 2015.

Results: One month post treatment the patient was relieved of headaches and back to full athletic activity.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of post-concussion syndrome.

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history multiple concussions resulting in headaches, fatigue, brain fog, nausea, dizziness and poor balance.

Conclusion: The results of this case suggest the necessity of further research into multimodal neurorehabilitation for the management of mild traumatic brain injury.

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Front. Neurol. Conference Abstract. 2015.

Conclusion: Due to improvements observed, the authors suggest further research into multimodal neurolorehabilitation approaches toward spastic paraplegia.

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: The results of this case suggest the necessity of further research into the use of multimodal neurorehabilitation in the management of mild traumatic brain injury.

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: A significant improvement in balance, headache, dizziness, photophobia, hyperacusis and anxiety was recorded.

MULTIMODAL NEUROREHABILITATION IMPROVES PATIENT WITH PROGRESSIVE APHASIA

Carrick FR, Traster D, Sass C, Sass B, Druckman E, Behrendt B, Arrieta | Front. Neurol. Conference Abstract. 2015.

Background: A 57 year old male presents with the chief complaint of progressive speech articulation problems spanning for the past two years.

Methods: A thorough neurological examination revealed apraxia of the left lower extremity, a positive Myerson’s/Glabella sign, and tongue deviation to the right side upon motor tasking of the extremities. The patient did not have deviation of the tongue upon tongue protrusion. The patient had paradoxical counterphase pursuit following in the horizontal and vertical directions that was more pronounced with increased speed of the pursuit target. A treatment plan involving repetitive peripheral somatosensory stimulation on the left side of the tongue, speech exercises, and specific oculomotor rehabilitation was performed.

Results: After four days of treatment the patient’s speech was dramatically improved, as well as appropriate pursuit following in all directions.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of aphasia.

MULTIMODAL NEUROREHABILITATION IN THE TREATMENT OF MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his mid 20s who presents with a history of multiple concussions resulting in headaches, loss of consciousness and speech difficulties.

NEUROREHABILITATION IMPROVES PATIENT WITH REPETITIVE TRAUMATIC BRAIN INJURIES

Carrick FR, Traster D, Esposito S, Antonucci M | Front. Neurol. Conference Abstract. 2015.

Results: The combination of treatment applications produced a profound reduction in all signs and symptoms.

PERFORMANCE OPTIMIZATION FOR ENHANCED LEARNING IN THE CLASSROOM: UTILIZING THE VESTIBULAR SYSTEM TO AFFECT CHANGE

Sockander L, Traster D, Behrendt B, Brenner K | Front. Neurol. Conference Abstract. 2016.

Background: Graduate law school student and athlete presented to the clinic to optimize performance in regards to her focus while studying.

Methods: A thorough neurological examination was performed and monitored along with pre/post diagnostic parameters including dynamic posturography (CDP), videonystagmography (VNG), saccadometry (SAC) and video head impulse testing (VHIT). Three therapy sessions in five days were performed and included therapies such as vestibular rehabilitation, repetitive somatosensory evoked potential stimulation (SSEP), non-invasive vagus stimulation and spinal and extra-spinal joint manipulation.

Results: Post therapy, the VNG revealed a decreased square-wave jerk (SWJ) activity with gaze holding and during pursuits. CDP testing increased specifically from fall with perturbed stance eyes closed (PSEC) head left and PSEC head extension to 63% and 54% stability respectively.

Conclusion: The patient had improved balance and gaze stability with only three therapy sessions. The authors suggest continued research in a multimodal brain-based rehabilitation approach to monitor any impacts on improved focus.

CHANGES IN VESTIBULAR FUNCTION FOLLOWING NON-INVASIVE MULTIMODAL BRAIN STIMULATION

Sockander L, Traster D, Behrendt B, Brenner K | Front. Neurol. Conference Abstract. 2016.

Background: We describe a 29 year old male professional hockey player who presented for performance enhancement.

Methods: A thorough neurological exam was performed with pre and post-therapy diagnostics including computerized dynamic posturography (CDP), Videonystagmography (VNG), video head impulse testing (vHIT), and Saccadometry (SAC). A brain-based therapeutic plan was applied combining vestibular, oculomotor, visual, proprioceptive and auditory rehabilitation.

Results: The patient went through seven therapy sessions over a period of 4 days. Post therapeutic diagnostics revealed improvement in vHIT testing from 19% asymmetry to 10% in the RALP testing. Over 5% improvement in stability was seen in computerized posturography measurements for testing of perturbed surface eyes closed, head neutral, head right, head left, and head extended.

Conclusion: Multi-modal brain-based rehabilitation techniques positively impacted vestibular function as evidenced by the objective diagnostic testing. It would be logical that improved vestibular function would result in improved athletic performance, however the authors suggest more research comparing multimodal vs unimodal forms of rehabilitation and performance enhancement. VOR integration is paramount to everyday activity and is vital in sport. A functional neurological integrated approach based off one’s neurological state can produce change. Change that can be seen diagnostically. This change can also equate to better functioning neurology and reflexogenic systems which may lead to increased performance. This optimization may also decrease chances of injury. The authors suggest further investigation into neurological approaches that can optimize performance.

MULTI-MODAL POST-STROKE REHABILITATION IMPROVES SPASTICITY DURING GAIT

Sockander L, Traster D, Behrendt B, Brenner K | Front. Neurol. Conference Abstract. 2016.

Background: Retired female presented for post-stroke rehabilitation in efforts to increase stability during gait. Over past two years she has had 4 episodes of syncope, where one episode resulted in the need for surgical intervention to mend ankle fracture in three locations. She states her left side of body has improved since the stroke, however she still has problems with stability and ambulation.

Methods: Thorough neurological exam performed along with diagnostic testing which included computerized dynamic posturography (CDP), Videonystagmography (VNG), Saccadometry (SAC). The patient underwent three therapy sessions in four days which included combinations of therapies such as vestibular canal re-positioning maneuvers, vestibular ocular reflex (VOR) exercises, multi-axial joint movements, non-invasive vagus nerve stimulation, low level laser, repetitive somatosensory evoked potential.

Results: Post therapy examination revealed improved spasticity and stability during gait. Rapid alternating movements improved, as did neck and back pain/stiffness.

Conclusion: Employing a multimodal brain-based therapy plan improved this patient’s ability to ambulate and improved every day function. The authors suggest further investigation into multi-modal rehabilitation in post-stroke rehabilitation.

REPETITIVE PERIPHERAL SOMATOSENSORY STIMULATION IMPROVES TRANSVERSE MYELITIS

Carrick FR, Traster D, Sass B, Sass C, Druckman E, Funk A, Acevedo J | Front. Neurol. Conference Abstract. 2015.

Background: A 57 year old female presents with the chief complaint of numbness, lack of motor control and loss of sensation bilaterally from the mid-trunk down to the feet. The symptoms started with a sudden overnight onset with no known cause or injury reported by patient. She had been wheelchair-bound since the onset of the anesthesia.

Methods: After an in-depth neurological examination, the patient demonstrated a right hypertropia with a left head tilt. Onychomycosis was present bilaterally at the toes, more so on the right than on the left side. The patient demonstrated brisk reflexes bilaterally and a bilateral Babinski response with excessive withdrawal. Sensory testing revealed intact sensation above the level of the umbilicus, but the patient revealed bilateral anesthesia below the level of the umbilicus. Videonystagmography (VNG) analysis revealed a right-beating nystagmus with fixation removed in the dark. The patient also revealed a consistent right corectasia throughout the VNG analysis. Optokinetic nystagmus was poor in both the horizontal and vertical directions. A treatment plan involving repetitive stimulation using a repetitive peripheral somatosensory stimulation starting at level of T9 and applying inferiorly to the sacral plexus, as well as low-level laser at the dermatomal level of T9 paraspinally was applied.

Results: After five days of rehabilitation the patient reported sensory gain on the trunk and lower extremities and regained normal visual optokinetic nystagmus responses.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of transverse myelitis.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION ON PATIENT WITH STIFF MAN SYNDROME

Carrick FR, Traster D, Sass B, Sass C, Peete F | Front. Neurol. Conference Abstract. 2015.

Background: A 26 year old male presents with a one year history of periodic episodes of muscle “freezes” consisting of extreme rigidity in the trunk and lower extremity.

Methods: A comprehensive neurological evaluation revealed long latency saccadic eye movements, tremors of the lower extremities, right Lateropulsion during rebound control testing with arms outstretched, bilateral intention tremors during upper and lower extremity testing that was more pronounced on the right side, accommodation spasm during various eye movements and severe blepheroclonus upon forced eyelid closure. Vestibular rehabilitation, application of ice to the right side face in the eye area, repetitive peripheral somatosensory stimulation, divergence eye exercises, and oculomotor rehabilitation was performed.

Results: After five days of treatment, the patient saw improvement in the frequency and intensity of his lower extremity tremors as well as improved global motor control. This treatment approach resulted in the most improvement in the patient’s symptoms compared to previous treatment approaches.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of stiff-person syndrome.

NEUROREHABILIATION IMPROVES DIPLOPIA AND NYSTAGMUS FOLLOWING TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Sass C, Sass B | Front. Neurol. Conference Abstract. 2015.

Background: A 26 year old professional athlete presents with post-concussive symptoms including diplopia following a severe traumatic brain injury that occurred five years prior.

Methods: A though neurological evaluation was performed and revealed abnormalities of eye movements were recorded in gaze holding, pursuit movements, saccadic eye movements, and optokinetic testing. A treatment approach involving vestibular stimulation, peripheral somatosensory stimulation, and oculomotor rehabilitation was administered.

Results: After three days of treatment, the patient reported an 80 percent improvement in the severity and occurrence of his diplopia.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

Carrick FR, Traster D, Esposito S | Front. Neurol. Conference Abstract. 2015.

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

Carrick FR, Traster D, Esposito S, Barton D | Front. Neurol. Conference Abstract. 2015.

Background: We describe a male in his 20’s who presents with a history of multiple concussions resulting in bilateral headaches, visual disturbances, dizziness and fatigue.

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Conclusion: The results of this case suggest the necessity of further research into the use of multimodal neurorehabilitation in the management of mild traumatic brain injury.

MULTIMODAL NEUROREHABILITATION IMPROVES VERTIGO AND DIPLOPIA

Carrick FR, Traster D, Sass B, Sass C, Funk A, Acevedo J | Front. Neurol. Conference Abstract. 2015.

Background: A 13 year old male presents with the chief complaint of diplopia and vertigo after sustaining two closed head injuries during athletics.

Conclusions: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the treatment of mild traumatic brain injuries.

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

Carrick FR and Traster D. | Front. Neurol. Conference Abstract. 2015.

Results: The patient no longer experienced any headaches and experienced significant improvements in her balance, dizziness, incontinence, swallowing and ability to lacrimate.

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

Results: A significant improvement in balance, headache, dizziness, photophobia, hyperacusis and anxiety was recorded.

IMPROVEMENTS OF MEMORY LOSS AND DIGESTION FOLLOWING MULTIMODAL NEUROREHABILITATION STRATEGIES

Carrick FR, Traster D | Front. Neurol. Conference Abstract. 2015.

UNILATERAL ARM AND LEG TREMOR IMPROVE FROM MULTIMODAL NEUROREHABILITATION

Carrick FR, Traster D, Sass B, Sass C, Funk A, Ranvik K, Behrendt B | Front. Neurol. Conference Abstract. 2015.

Results: After four days of treatment, the patient reported a complete resolution of the tremor, improvement in gait and stance, and the ability to play the piano again.

Conclusion: The authors suggest further investigation into comprehensive, multimodal forms of neurorehabilitation in the management of tremor.

Case Studies

Research + Findings

IMPROVEMENT IN ACHALASIA FOLLOWING A NEUROLOGICAL REHABILITATION PROGRAM

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Significant Improvement in Severe Anxiety of 20 years Duration following Conservative Neurologic Rehabilitation program: A Case Study

ATAXIA IMPROVED THROUGH APPLICATION OF MULTIMODAL NEUROREHABILITATION APPROACH

FUNCTIONAL IMPROVEMENTS IN A PATIENT WITH TRAUMATIC BRAIN INJURY AND DYSTONIA FOLLOWING INTEGRATED NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

68-YEAR-OLD FEMALE WITH APALLESTHESIA IMPROVED THROUGH BRAIN-BASED REHABILITATION: A CASE STUDY

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

ATAXIA IMPROVED THROUGH APPLICATION OF MULTIMODAL NEUROREHABILITATION APPROACH

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

MULTIMODAL NEUROREHABILITATION IN PATIENT WITH SPASTIC CEREBRAL PALSY

COMPLEX REGIONAL PAIN SYNDROME IMPROVES AS A RESULT OF MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IN YOUNG BOY WITH COMPLEX REGIONAL PAIN SYNDROME

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

IMPROVEMENTS IN A PATIENT WITH MILD TRAUMATIC BRAIN INJURY AND DYSLEXIA FOLLOWING MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

IMPROVEMENTS IN MILD TRAUMATIC BRAIN INJURY THROUGH MULTIMODAL NEUROREHABILITATION

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

INTEGRATIVE NEUROREHABILITATION IMPROVES POST-CONCUSSION SYNDROME

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

FUNCTIONAL IMPROVEMENTS IN A PATIENT WITH TRAUMATIC BRAIN INJURY AND DYSTONIA FOLLOWING INTEGRATED NEUROREHABILITATION

POST-CONCUSSION SYNDROME IMPROVES THROUGH MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IN THE TREATMENT OF MILD TRAUMATIC BRAIN INJURY

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

NEUROREHABILITATION IMPROVES PATIENT WITH REPETITIVE TRAUMATIC BRAIN INJURIES

MULTIMODAL NON-ACUTE NEUROREHABILITATION IN THE TREATMENT OF SEVERE TRAUMATIC BRAIN INJURY

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

BALANCE AND HEADACHE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY IMPROVE WITH MULTI-MODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES VERTIGO AND DIPLOPIA

Resolution of professional hockey players’s concussionsymptomatology allowing him to return to play following abrain-based therapy approach: a case study

100% Improvement of Symptoms in Post-Concussion Syndrome in a Twenty-One Year Old College Female as a Result of Neurological Rehabilitation

Five-Day Multimodal Rehabilitation For A 39 Year-Old Female With Post-Concussive Syndrome Results in a 93% Improvement in Symptoms

Five-Day Multimodal Rehabilitation For A 41 Year-Old Female With Post-Concussive Syndrome Results in a 59% Improvement in Symptoms

Five-Day Multimodal Rehabilitation For A 25 Year-Old Female With Post-Concussive Syndrome Results in a 68% Improvement in Symptoms

Three-Day Multimodal Rehabilitation For A 48 Year-Old Female With Post-Concussive Syndrome Results in a 68% Improvement in Symptoms

CONSTIPATION IMPROVED THROUGH BRAIN-BASED REHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

NEUROREHABILITATION IMPROVES PATIENT WITH REPITIVE TRAUMATIC BRAIN INJURIES

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

NEUROREHABILITATION FOR PATIENT WITH DYSAUTONOMIA

VASOVAGAL SYNCOPE IMPROVES AFTER MULTIMODAL NEUROREHABILITATION

Resolution of postural orthostatic tachycardic syndrome following a brain-based therapy approach

VERTIGO IMPROVED WITH MULTIMODAL NEUROREHABILITATION PROGRAM

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES TEENAGE FEMALE WITH MILD TRAUMATIC BRAIN INJURY

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

POST CONCUSSION VERTIGO AND HEADACHES IMPROVE AFTER MULTIMODAL NEUROREHABILITATION

IMPROVEMENTS IN MILD TRAUMATIC BRAIN INJURY THROUGH MULTIMODAL NEUROREHABILITATION

MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH AN INTEGRATED NEUROREHABILITATION APPROACH

INTEGRATIVE NEUROREHABILITATION IMPROVES POST-CONCUSSION SYNDROME

TEENAGE MALE WITH MILD TRAUMATIC BRAIN INJURY IMPROVED THROUGH A COMPREHENSIVE NEUROREHABILITATION REGIMEN

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

MULTIMODAL NEUROREHABILITATION IMPROVE MILD TRAUMATIC BRAIN INJURY

MULTIMODAL NEUROREHABILITATION RESOLVES SEVERE VERTIGO

POST-CONCUSSION DIZZINESS IMPROVES FROM MULTIMODAL NEUROREHABILITATION

MULTIMODAL NEUROREHABILITATION IMPROVES BALANCE IN PATIENT WITH MILD TRAUMATIC BRAIN INJURY

SPASTIC PARAPLEGIA IMPROVES WITH MULTIMODAL NEUROREHABILITATION

Resolution of professional hockey players’s concussion
symptomatology allowing him to return to play following a
brain-based therapy approach: a case study