The main causes of concussions are typically anything that involves a head injury. This can include sports activities, and all too frequently, automobile accidents. Severe concussions, because of the immediate symptoms, are often followed up upon with medical care. It is however the less severe impacts that can become more problematic as these are not always brought to the attention of a medical person. In addition to neurologic symptoms which can develop following even a mild concussion, even more serious is something called second impact syndrome, whereby an individual with a concussion has a second one and has not yet recovered from the first. This can be so severe that it can actually be life threatening. For these reasons any suspect concussion, i.e. any head trauma, should be followed up for appropriate examination by a medical person well trained in post concussive injuries. The most common symptoms following a concussion include sensitivity to lights and sounds, and often altered sense of smell and difficulty reading. The latter is often inappropriately thought to be due to age related deterioration in vision, but is in fact due to an inability to properly place the eyes in the correct position and keep them there while viewing a target, or while moving the eyes from one target to another, or while following a target, as occurs with reading. My office is used to seeing patients who have had an untreated concussion years ago only to find worsening symptoms now. Naturally these are much easier to treat earlier on.
Things that you can do if you believe you may have had a concussion: The simplest thing you can do is come in to our office for a balance test. The test takes less than one minute to perform and yields an extraordinary amount of data relative to you postural systems and your brains ability to resist the earth’s gravitational pull properly, i.e. risk of fall. Our office does not charge for this service as we offer it as a free community service. Our office is additionally equipped with a complete balance center, including infrared video goggles which allow us to record and watch your eyes while following targets on a computer screen in real time. This information is essential to properly treat someone whose brain has been injured.
Well, I suppose that I must apologize for my most unexpected hiatus as I now have many readers anxious to read my weekly column on various health issues. As ironic as it may be, as I run a rather successful balance center, the reason for my hiatus was from a fall. I had broken my ankle tearing all of the connecting ligaments in an accidental fall, which occurred while I was watering plants in my family room. I had apparently spilled some of the water on the floor, which I later slipped on causing the injuries. So in addition to my apologies for missing several weeks of writing to you, why do I bring this up? Simple. The lesson to be learned here is how quickly accidents can happen. Now in my case, I practice what I preach and check myself regularly for fall risk, something that takes less than a minute with the computerized equipment we use in my laboratory. However, many more people will incur injuries such as mine, which will be more than purely accidental, attributable to an untreated balance problem, making accidents like mine somewhat inevitable. This concerns me greatly having gone through this, as it is certainly no fun being incapacitated and completely reliant on others for a length of time. And the lower the level of health you are in, or the more complicating factors you have, such as diabetes, the longer that period of time will be. To complicate matters even further, many people with disturbed balance, think that they are normal because they have no way to determine otherwise without being tested. In light of this endemic disabling problem, we screen as many individuals as we can get though our doors, for free, each day. For those who pass the simple 30-second test, you are assured that your balance is as good as it should be. For those who do not do so well, we can make treatment recommendations so that in short time, your balance will be as good as it should be and thus minimizing risk of fall and the incapacitating disability associated with falling. Many more falls occur from disorders like vertigo and dizziness, things that are easily treated in my office. If you have vertigo, dizziness, or an increased risk of fall from poor balance, you don’t need a wet floor to assist you in losing your balance and falling and injuring yourself, it will happen much easier without assistance. Anyone who wishes to be screened can do so by calling our office and scheduling a screening. There are absolutely no strings. You pass, you go home with a congratulatory handshake. For those who would like more information, our website has a myriad of information on dizziness and balance problems. We even offer a free consultation questionnaire that you can submit for consideration to determine the nature of your particular problem should you have one. I would like to thank my many readers for your support and I again apologize for my unexpected absence. I hope to see many of you in my office for screenings.
Many patients that we see have seemingly bizarre symptoms that they have been living with for long periods of time, resultant to changes in the way their brain is functioning. These neurologic findings are sometimes attributable to post-concussive syndromes, following an accident or other head injury, and sometimes not and are caused by other environmental factors. The symptoms that occur often include imbalance or dizziness, tremor, headache, wincing of one or both eyes, tearing, fear of light, (photophobia), intolerance to sounds, (hyperacusis), reduced or deteriorating handwriting, (micrographia/dysgraphia), cognitive loss, personality/behavioral change, and on and on. If these neurologic symptoms are as a result of a structural abnormality, they are usually caught long before the patient is referred to my office. However, when there is no underlying demonstrable change, i.e. on MRI, this points to a neurophysiologic problem. Neurophysiologic problems are such that they cannot be seen on imaging studies. It would be like taking a picture of your car to try and figure out why the motor won’t start. These types of problems can only be observed on clinical examination of a patient and by utilizing other non-imaging type examinations such as the neurodiagnostic equipment found in my office. The good news is that if no structural lesions are involved, there is often a good chance of complete recovery once the diagnostic dilemma is uncovered and appropriate functional neurologic rehabilitation is utilized. The patients that we see with these types of problems refer to my office misdiagnosed, or undiagnosed. Often they are on drugs that they have no idea why they are taking, and which are not only not helpful, but oftentimes harmful. (Whenever you are prescribed a drug, you should ask why). They have seen several doctors and have had batteries of tests. We particularly enjoy working with these types of patients, as when they get better the joy is heartfelt by all.
As you are probably no doubt aware by now, my office spends much time dealing with patients who suffer with vertigo, dizziness, balance loss and dystonia. What you are probably not aware of is that many of these patients got that way in the first place as a result of being involved in a motor vehicular accident some time in the not too distant past, usually within five years or so. Nonfatal car accidents cause many problems, ranging from neck and back pain to vertigo and dystonia, a painful condition causing spasm only on one side of the neck, which results in an oscillatory tremor of the head. Although we can treat patients with these conditions rather successfully, the problem lies in the fact that many affected individuals fail to present to our office until some time after these conditions have already manifested and become severe. Even then, while treatment may be successful, it is usually unnecessarily lengthened because of the delay from the time of manifestation to the time of diagnosis. The reason why these conditions are usually associated with motor vehicle accidents is because motor vehicle accidents oftentimes involve mild head trauma. You don’t have to be in a car accident for this to happen. Any type of head trauma can cause similar problems. For example, reaching under a sink to find an item far in the back and bumping your head on the way up can oftentimes result in vertigo within the next few days. Even that occasional trivial bump on the head from inadvertently banging it can lead to vertigo. This is also more common in the elderly although possible in any age group. Further, this type of vertigo is actually the fastest from which individuals respond to treatment, so if you suffer with this type of vertigo, you are suffering unnecessarily. If you have any type of dizziness, vertigo or dystonia type symptomatology or if you have been involved in a motor vehicular accident, then you should be thinking about being evaluated. These are not good problems to have as they invariably lead up to a fall, which causes things such as hip fractures, emboli, stroke, et cetera. My office is furnished with all of the necessary equipment to screen for risk of fall, which only takes seconds, and we do not charge for this service. However, you must take advantage of this service to derive any benefits from it.