Multimodal neurorehabilitation of a patient with tinnitus and memory difficulties

Abstract

Event Abstract Back to Event Multimodal neurorehabilitation of a patient with tinnitus and memory difficulties Matthew M. Antonucci1, 2, Jeremy Husk3 and Susan E. Esposito3* 1 Plasticity Brain Centers, United States 2 Carrick Institute for Graduate Studies, United States 3 Life University, United States Background: We describe a 61-year-old male who presented to a functional neurology clinic with tinnitus, memory changes, sleeping issues, and fatigue as his chief complaints. Additional complaints were anxiety, back pain, depression, and abnormal psychological changes. The patient had previously received treatment at the same facility three months prior and reported that his symptoms of “chatter” in his head had decreased, he felt calmer, his mood was much better, and he no longer experienced his “post traumatic stress disorder (PTSD) symptoms.” He also noted that he tried to stop taking his Wellbutrin, an antidepressant medication, but it “did not go well.” The patient’s symptoms are consistent with a bipolar disorder diagnosis, but the severity since his last treatment had greatly diminished. Methods: A physical exam revealed several significant abnormal findings. The examiner noted a decreased left arm swing and lateropulsion during a dual tasking gait test. The patient exhibited bilateral dysmetria on finger-nose-finger testing with the greatest deficit occurring in the lower left quadrant; left extensor muscle weakness; and an 8-10 hz tremor of the chin and hands. Also, square wave jerks were present in all eye positions and with without fixation, nystagmus was manifest in an up and rightward beating direction. Rightward saccadic intrusions were noted during right and leftward pursuits. Lastly, there was an increased gain of the optokinetic response going leftward, rightward, and downward. Following the examination, the patient participated in a 5-day multimodal neurorehabilitation program that included several specific rehabilitation efforts. Therapy included vestibular rehabilitation, gaze stability exercises with head movements, and ocular fixation exercises. Additionally, repetitive peripheral somatic stimulation (RPSS) of the mandibular nerve, passive complex non-linear limb movements, and off vertical axis rotations; as well as basic balance training and hand eye coordination activities were utilized. Results: After 5 days of treatment, the patient reported decreased tinnitus, decreased memory difficulties and experienced an increase in both the quality and duration of sleep. Examination revealed a decrease in bilateral dysmetria during the finger-nose-finger testing, resolution of muscle weakness, smooth pursuits in all directions, and fewer square wave jerks. The patient retained a decrease in left arm swing during dual task gait testing, but his lateropulsion was completely resolved. Conclusion: This case showed significant neurological improvements after administration of the multimodal neurorehabilitation regimen described. The authors have suggested further investigation into vestibular rehabilitation mechanisms and brain-based approaches for patient treatments of various cognitive and neurological complaints. Keywords: Tinnitus, Memory Disorders, PTSD Symptoms, chiropractic neurology, Neurorehabilitation Conference: International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function, Orlando, United States, 7 Oct - 9 Oct, 2016. Presentation Type: Poster Presentation Topic: Abstracts ISCN 2016 Citation: Antonucci MM, Husk J and Esposito SE (2016). Multimodal neurorehabilitation of a patient with tinnitus and memory difficulties. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function. doi: 10.3389/conf.fneur.2016.59.00031 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 31 Aug 2016; Published Online: 07 Sep 2016. * Correspondence: Dr. Susan E Esposito, Life University, Marietta, United States, susanesposito@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Matthew M Antonucci Jeremy Husk Susan E Esposito Google Matthew M Antonucci Jeremy Husk Susan E Esposito Google Scholar Matthew M Antonucci Jeremy Husk Susan E Esposito PubMed Matthew M Antonucci Jeremy Husk Susan E Esposito Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.