Concussion is one of the most common forms of head injury and can have serious consequences for the patient's quality of life and ability to function. However, with the right diagnosis and treatment, concussion patients can experience significant recovery and rehabilitation. In this blog post, we will explore what concussions are, how they affect patients, and how functional neurology can be an effective form of treatment for this condition.
What is a concussion and how can it affect you?
A concussion occurs when the head is subjected to a strong impulse, which can be caused by a blow to the head, face, neck or other parts of the body. This can lead to changes in the brain, which can result in a range of symptoms and distress. These symptoms can range from somatic, cognitive and emotional symptoms to physical signs, impaired balance, behavioral changes, cognitive impairment, headaches, migraines, sleep/wakefulness disturbances, dizziness and neck stiffness.
Concussion can be diagnosed using symptoms and clinical tests, as there will be no findings on MRI, CT or X-ray. A correct diagnosis is important in order to provide the right treatment and rehabilitation.
Concussion vs. whiplash: Differences in symptoms
While concussion and whiplash can both lead to headaches and difficulty concentrating, it is important to distinguish between the two conditions. Whiplash usually occurs after a forceful movement of the head and neck, which can lead to headaches, pain in the neck, shoulders and back.
The symptoms of concussion can be more extensive and may also include neurological deficits, impaired balance, loss of consciousness, memory loss, impaired eye motor function and cognitive disorders.
Sports-related concussions: Preventive measures and rehabilitation
Athletes, especially in contact sports such as American football and ice hockey, are particularly prone to concussions. In American football, 100-200,000 athletes suffer a head injury annually. There are at least 300,000 sports-related concussions per year in the US. In the Swedish elite ice hockey league, over 20% of players suffer one or more head injuries during their career. Horseback riding is the sport where athletes most frequently injure their heads when an injury situation first occurs; over 90% of riding injuries involve the head. A football at full power can reach a speed of 120 km/h. However, in football, head injuries most often occur after head-to-head, head-to-elbow/knee and head-to-goalpost impacts.
Preventive measures such as wearing a helmet and a mouth guard can help reduce the risk of injury. However, it is important to be aware of concussion symptoms and report any suspected cases to medical personnel. When treating sports-related concussions, functional neurology can also be an effective approach. Specific exercises that focus on balance and eye motor skills can help improve brain function and reduce the risk of persistent symptoms.
Fall-related concussions: Prevention and rehabilitation
Falls are a common cause of concussion, especially among older adults. Preventive measures such as proper lighting, using non-slip rubber soles, and eliminating potential hazards in the home can help reduce the risk of falls. Rehabilitation after a fall-related concussion may include functional neurology, which can help restore brain function and improve balance and coordination. Treatment may also include exercises to improve vision and eye motor skills, as well as other therapies such as massage and spinal manipulation. With proper rehabilitation, older adults with concussions can experience improved functional ability and reduced risk of future falls.
Diagnosing concussion and classifying symptoms: How functional neurology can help.
Diagnosing a concussion can be challenging, as there are no structural changes that can be detected in standard imaging diagnostics. The diagnosis is usually made through a combination of symptoms and clinical tests. Classification of symptoms can help to identify which areas of the brain are affected and target treatment in a more specific way. Functional neurology can be useful in this context, as it can help to identify and treat specific areas of the brain affected by the concussion. Classification of symptoms can include categories such as:
- Autonomic - Affects blood pressure, heart rate, pulse, pain
- Oculomotor/Vision - Visual disturbances
- Affect - Emotions
- Cognitive - Mentally tired, brain fog, fatigue
- Headache - Headache, migraine
- Cervical/Somatic - Neck pain and generally more bodily pain
- Vestibular - Unsteady, dizziness, headache, fatigue
A thorough assessment and classification of symptoms can help develop a treatment plan that is tailored to the individual patient's needs and can increase the chances of successful rehabilitation.
Sequelae after concussion (Post Commotio) and long-term sick leave:
Many patients with concussions continue to experience pain and symptoms even several months after the injury. A study from Denmark followed 18,000 patients (age 18-60) with post-concussion over a 5-year period. 43% of these patients were not back at work after 5 years. The symptoms of PCS can include symptoms such as headaches, balance problems, fatigue, sleep disturbances, concentration difficulties and mood swings. These symptoms can affect the patient's quality of life and ability to work or participate in daily activities. Functional neurology can also be useful in treating PCS and helping the patient restore function and quality of life. It is important to discuss these issues with your doctor and seek help from a specialist if you are still experiencing symptoms after a concussion.
Research:
- PLOS ONE in 2020 "Subconcussive impacts attenuate neurocognitive performance: a systematic review and meta-analysis". This study shows that subconcussive blows can also affect the brain's ability to learn. This was demonstrated in a study from 2020, which found that athletes who had been exposed to repeated minor blows to the head had impaired cognitive function and learning ability.
- Journal of Frontiers in Neurology in 2019, and is entitled "Functional Neurology-Based Management of Post-Concussion Syndrome: A Case Series". The study investigated the effect of functional neurology treatment on patients with post-concussion syndrome (PCS). The researchers followed a group of 24 patients who received treatment for 12 weeks and evaluated their symptoms and quality of life before and after treatment. The results showed a significant reduction in symptoms such as headache, fatigue, dizziness and cognitive problems, as well as an improvement in quality of life.
- Journal of Neurology in 2018, and is entitled "Effectiveness of vestibular rehabilitation in the treatment of balance deficits in adults with a history of mild-to-moderate traumatic brain injury: a systematic review and meta-analysis". The study investigated the effect of vestibular rehabilitation on balance problems in adults with a history of mild-to-moderate traumatic brain injury. The researchers collected data from 14 studies that included a total of 644 participants and evaluated the effect of vestibular rehabilitation on balance and symptoms such as dizziness, nausea and headache. The results showed that vestibular rehabilitation was effective in improving balance and reducing symptoms in patients with a history of mild to moderate traumatic brain injury. The researchers concluded that vestibular rehabilitation should be an important part of the rehabilitation program for patients with balance problems after a head injury.
- A study conducted in Denmark investigated the effect of functional neurology in the treatment of patients with post-concussion syndrome. The study found that patients who underwent functional neurology experienced a significant reduction in symptoms such as headache, fatigue and difficulty concentrating. The researchers concluded that functional neurology can be an effective treatment method for patients with post-concussion syndrome and help them restore function and quality of life. It is important to note that treatment must be tailored to the individual patient's needs and symptoms, and a combination of different approaches may be required to achieve the best possible outcome.
