Nonpharmacological Treatment of Postconcussion Syndrome

Abstract

A concussion is a mild form of traumatic brain injury that results in symptoms of headache, dizziness, fatigue, and concentration or memory difficulty. Postconcussion syndrome is defined as the persistence of these symptoms beyond 3 months. These initial symptoms can be debilitating and can lead to further physiological or psychological impairments such as depression, slowed processing speed, and gait imbalances. Although pharmacological interventions with antidepressants and stimulants may be useful, some patients may not accept or adequately respond to these interventions. A nonpharmacological approach to treating postconcussion syndrome uses a holistic approach to treat both the mind and body. Nonprescription therapies include vestibular rehabilitation for dizziness, vertigo, and balance/gait difficulties, as well as cognitive-behavioral therapy for both somatic and neuropsychiatric symptoms. The timing and ratio of rest versus rehabilitation through activity is case specific and a matter of ongoing clinical judgment given the uniqueness of each injury and the variety of postconcussive presentations. [ Psychiatr Ann . 2017;47(2):88–91.]