Treatment of a 25-year-old female with severe motion sickness, positional dizziness, and anxiety using a novel sensorimotor and vestibular rehabilitative approach.

Abstract

Event Abstract Back to Event Treatment of a 25-year-old female with severe motion sickness, positional dizziness, and anxiety using a novel sensorimotor and vestibular rehabilitative approach. Marc C. Case1* 1 Case Chiropractic Neurology Center, United States Presentation Motion sickness is a very common condition with myriad associated symptoms and triggers. Patients presenting with motion sickness should undergo extensive history and examination to determine most relevant causative components to their symptomatology, allowing appropriate diagnosis and treatment. A 25-year-old female patient presents to our clinic with long-standing history of severe motion sickness, positional dizziness, and anxiety. Examination Clinical infrared video goggle assessment revealed bilateral square wave jerks, hypermetric rightward saccades, left eye accommodation spasm, left lateral and left vertical gaze fixation instability, right eye accommodation spasm upon return to center from right horizontal gaze fixation, and hippus bilaterally. Force plate posturography revealed an average baseline center of pressure (COP) path length of 40cm during Fall Risk Assessment (FRA) on a firm surface with eyes closed, indicating a high fall risk, and a baseline composite COP path length of 177cm during modified Clinical Test of Sensory Integration and Balance (mCTSIB). Heart rate sit to stand measured 81 BPM seated to 93 BPM standing right, and 83 BPM seated to 97 BPM standing left. Tissue oxygenation saturation measured 96% bilaterally. Neurological examination revealed saccadic rightward pursuits, saccadic vertical pursuits, hypermetric leftward saccades, slight right palatal paresis, mild palmar hyperhidrosis bilaterally, hypermetria with right finger to nose, dysdiadochokinesia of the right upper extremity, right glossal deviation, and fasciculations of the left posterior deltoid and bilateral cervical spinal musculature with eyes closed standing on firm surface. Intervention Due to time restrictions, the patient was only able to be seen for two treatments in a single day. A brain-based, multimodal treatment approach included vestibular rehabilitation maneuvers, vestibular-ocular re-training, individualized eye movement therapies, sensorimotor integrative therapies, and specific at-home neurologic exercises. Re-examination was performed following treatments. Repeat force plate posturography revealed an average baseline COP path length of 20cm during FRA on firm surface eyes closed, indicating a low fall risk (50% improvement) and a baseline composite COP path length of 115cm during mCTSIB (62cm improvement). At the 6 week follow-up, the patient reported a maintained significant reduction in frequency and severity of motion sickness and anxiety, with complete resolution of positional dizziness. Conclusion A 25-year-old female with severe motion sickness, anxiety, and positional dizziness sees immediate, significant, and lasting results within a single-day, 2-treatment clinical timeframe. This case study reveals a hopeful and conservative approach to treatment of chronic motion sickness and associated symptoms. Further investigation is warranted for interventions involving brain-based, multimodal therapies for motion sickness, positional dizziness and anxiety. Figure 1 Figure 2 Keywords: Motion Sickness, Anxiety, Dizziness, vestibular rehabilitaiton, sensorimotor Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Case MC (2019). Treatment of a 25-year-old female with severe motion sickness, positional dizziness, and anxiety using a novel sensorimotor and vestibular rehabilitative approach.. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00046 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: 02 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Dr. Marc C Case, Case Chiropractic Neurology Center, St. Marys, United States, marc.case15@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 Marc C Case Google Marc C Case Google Scholar Marc C Case PubMed Marc C Case 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.