Concussed patients can sometimes develop autonomic symptoms that look like POTS, but a recent study showed that these patients likely have some important differences
A retrospective case review at a pediatric concussion center showed about 7% showed objective signs of autonomic dysfunction and tachycardia on standing
The goal shouldn’t be to avoid something harmful indefinitely. It’s to prepare our bodies for the world we live in by gradual exposure. It’s a core principle of many rehab strategies
We are often told that we need to eliminate our exposure to different physical, chemical, or emotional stressors. But elimination of stresses isn’t necessarily ahold thing. Our bodies need some stressors to become stronger
Here are some examples. Exercise is the most familiar example of something that causes us damage that makes us stronger. But the concept applies to sunlight and even exposure to germs and allergens
Disruptions in the vestibular or eye movement pathways in the brain stem can create torsion of the eye.
If the brain doesn’t compensate well, this can be associated with feelings of imbalance, neck pain, and headaches
Vestibular exercises and balance training may help even without an active lesion.
Exercises may facilitate improved compensation, but more importantly it might reduce fear and improve self-efficacy of a patient’s balance systems
BPPV is the most common cause of vertigo and fortunately has a non-invasive and highly successful treatment.
While vertigo resolves in upwards of 90% of patients, many patients may still feel a residual sense of dysequilibrium after successful repositioning maneuver 1/
Residual dizziness was associated with psycho-social factors. Similar in some ways to chronic pain where fear and catastrophizing can play a role, on top of the usual suspects of anxiety/depression.
However, we shouldn’t discount the role plasticity or compensation may play
The gut microbiome may play an important role in the development of neurological disease. It’s too early to tell, but it may open an avenue for future treatment