Event Abstract Back to Event Treatment of a 51-year old male presenting with a history of multiple concussions, persistent pain, and cognitive deficits using a novel sensorimotor and vestibular rehabilitative approach. Shannon Leon1, Marc Case1 and Jason Langhough1* 1 Dr. Shannon Leon Functional Neurology, United States Background A 51-year old male presents to a functional neurology office reporting difficulty word-finding, dizziness, poor balance, gait instability, blurred vision, inability to multitask, extreme fogginess, focus and attention deficits, inability to communicate with peers, affect dysregulation, and chronic pain in the neck, low back, and legs. The patient had been seen by a medical neurologist and was diagnosed with post-concussive syndrome. He was referred to physical therapy for pain management before arriving at our office. A brain MRI was negative. Methods Dynamic posturography testing revealed primary deficiencies involving the right otolith and right posterior semicircular canal. Videonystagmography assessment confirmed a 1-2 second time constant in both left gaze fixation and up-and-left gaze fixation, decreased velocity of right saccades, right convergence spasm, right internuclear opthalmoplegia, left ptosis, left corectasia, and decreased amplitude and frequency of the left vestibulo-ocular reflex. Neurological examination revealed right finger tapping was bradykinetic with intermittent hesitations, right finger-to-nose was dysmetric, and right dysdiadochokinesia with rapid alternating movements. Patient was diagnosed with a functional disorder involving the right cerebellum, right parietal lobe, left frontal lobe, right mesencephalon, left pons, left basal ganglia, and a bilateral vestibular impairment. A multimodal treatment plan included vestibular repositioning maneuvers, vestibulo-ocular retraining, specific eye movement therapies, joint manipulation of the spine and extremities, and nutritional counseling focusing on a low carbohydrate, low sodium, whole food, plant-based protocol. Results The patient was seen 2-3 times per week for the first three months, followed by weekly visits for two months. After five months of brain-based therapies, objective measures of gaze fixation, smooth pursuits, saccades, optokinetic nystagmus, vestibulo-ocular reflexes, and posturography were within normal limits. Subjective measures indicate resolution of pain, dizziness, fogginess, speech disfluency, attention deficits, cognitive dysfunction, and affect dysregulation, leading toward a full recovery of his activities of daily living and a return to work. Conclusion A middle-aged male with history of multiple concussions and persistent pain sees resolutions of cognitive dysfunction and physical complaints following multimodal brain-based therapies. Further investigation is warranted for interventions involving brain-based therapies for the treatment of post-concussive syndrome. Keywords: Post concussion syndrome, Vestibular rehabilitation therapy, specific eye movement therapy, Brain Based Rehabilitation, novel therapies 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: Leon S, Case M and Langhough J (2016). Treatment of a 51-year old male presenting with a history of multiple concussions, persistent pain, and cognitive deficits using a novel sensorimotor and vestibular rehabilitative approach.. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function. doi: 10.3389/conf.fneur.2016.59.00003 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: 26 Aug 2016; Published Online: 07 Sep 2016. * Correspondence: Dr. Jason Langhough, Dr. Shannon Leon Functional Neurology, Woodbury, New York, United States, j.langhough@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 Shannon Leon Marc Case Jason Langhough Google Shannon Leon Marc Case Jason Langhough Google Scholar Shannon Leon Marc Case Jason Langhough PubMed Shannon Leon Marc Case Jason Langhough 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.