Case Presentation: 11 year-old male presents with a history of vasovagal syncope and symptoms of dizziness, nausea, headaches, depression, anxiety, photophobia, and hyperacusis
We are describing 11-year-old male who presents to a functional neurology clinic with a history of vasovagal syncope and symptoms of dizziness, nausea, headaches, depression, anxiety, photophobia, and hyperacusis.
Evaluation Parameters
During this examination, the patient demonstrated positive Romberg’s, inability to stand unassisted with pulsivity in all directions with a predominance of leftward retropulsivity. The patient demonstrated decreased left patellar reflex, hyperacusis on the right, saccadic intrusions in leftward and upward as well as saccadic eye movements away from any light stimulus. All aberrant eye movements were confirmed by videonystagmography. The patient participated in a two-week vestibular rehabilitation program that included multi-axis labyrinth and otolithic stimulation paired with specific eye movements and exercises.
Jessica Sears presents her thoughts on this case presentation.
I’m lucky working in a multi-functional clinic so my role in these situations is basically just to help relax the muscles in conjunction of what I’m hearing from my physios and my ATs. Basically, it’s light occipital work, going into some of the neck muscles as much as we’re able to work. We don’t wanna over-irritate or we don’t wanna inflame the muscles, so it’s basically just a light relaxation that does help a little bit with the signs and symptoms that he is presenting with, especially with the depression, and changing a little bit of the symptoms with some different… Changing some of the different aspects that he’s presenting with. Some craniosacral work, again very light, not too much. If it is inducing some irritation or some inflammation, kind of goes by treatment.
Those treatments would probably be hopefully 20 to 30 minutes, but it goes by situation. So every appointment, we’ll go with how the client has spent the last few days or last treatments and we go from there. Be evaluating and hopefully getting to full treatment, but going with what they’re presenting with on that day and sometimes even cancellations of the appointment if they’re not able to come in because they’ve been over-irritated just with what they’ve been going through in the early morning or early day.
So that’s pretty much where or how I can treat this situation. It’s not really something that we can say that we can go dig in as much as we would want to, but it’s light and kind of depending on how the client presents.
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Jessica Sears Bsc Kin, RMT, SMT (C)
Jessica graduated with a Bachelors of Science in Kinesiology in 2003 and in 2005, she graduated from the Kiné Concept Maritimes Inc. School in Massage Therapy. Since then, she worked nine years at Champlain Physiotherapy, as a Kinesiologist and Massage Therapist and recently has moved her clinic to Protherapy. She has been selected as Team Therapist with Team Atlantic, for the National Women’s Under 18 Hockey Championship in 2011, Team Canada-Atlantic for the World Under 17 Hockey Challenge in 2013 and 2014. Currently Jessica is the Vice President for the Canadian Sport Massage Therapists Association.
Biomechanist on vasovagal syncope and symptoms of dizziness, nausea, headaches, depression, anxiety, photophobia, and hyperacusis
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