PCS & Dizziness
 

Hi,

In the middle of March 2011, I bumped my head getting out a small aircraft, a Cessna 172. I didn't blackout or lose consciousness. I got a headache and took an Advil.

Two days later, I experienced my first migraine headache while playing soccer. Because of my migraine symptoms - numbness in right hand and face, slurring of words and difficulty even thinking clearly, I went to the hospital the next day.

I've had a cat scan and MRI and both were negative. The neurologist thinks I was experiencing all of the classic symptoms of a migraine. He ordered the tests just because it was my first migraine.

However, about 4 or 5 days after the migraine episode, I started experiencing a mild dizziness - not vertigo. I have it almost every day since.

My lightheadedness is mild - I can still drive and work (I'm an engineer) and I'm experiencing no other symptoms at all. If I keep my head still (like working on a computer or watching tv), then it "goes away". However, if I turn my head quickly, look up/down/left/right then I feel dizzy.

I have had bloodwork and an EKG which both were fine.

I have been going to a physiotherapist since the beginning of June 2011 for vestibular rehabilitation. My balance has been getting better, however, I still feel the same level of dizziness (5 out of 10) all the time.

I feel more dizzy while at a busy mall (like Costco) or when in a car stopped at a light or in traffic.

I'm going to see my family doctor tomorrow on the referral of my PT in hopes of getting referred to a different neurologist (one that specializes in concussions vs. the one I saw who specializes in strokes) or an ENT (Ear-Nose-Throat specialist).

I have been to a chiropractor, but after a few weeks of no improvement, he suggested that I stop treatment for a while to see if it makes any difference. I haven't been to see him in over 2 weeks. I don't feel any worse.

I also have an appointment booked with an Osteopath who practices cranial massage to see if that makes any difference. I had wondered about seeing an acupuncturist, but my PT also does acupuncture and she didn't think that would help.

I'm 27 years old, non-smoker and I don't drink.

I live in Calgary, Alberta, Canada - if anyone has some suggestions on a good concussion neurologist or ENT or any other specialist to see, please let me know.

Thanks.
Dan

So sorry you are having migraines. I started having migraines when I was young but then developed a different kind of migraine/migraine-like headache after my concussion. Mine have now gone away except for after very long bike rides (4+ hours). If I don't ice my neck right after I will get a terrible, throbbing headache.

I also had balance problems and vertigo. Again, very likely related to the neck injury.

I flew to Buffalo to see Dr. Leddy at the University of Buffalo concussion clinic. He is the one that cleared me to get back on my bike and sent me off to physical therapy for my neck. Here is a detailed post: http://neurotalk.psychcentral.com/post775819-12.html

I'm not saying your problems are caused by a neck injury, but it's definitely worth looking into. Good luck!

Did you find the UB clinic helpful?
 

Chitown, did you find the advice you received at the UB clinic helpful? Have you been able to address your neck issues since then?

I find it odd that there is next to no anecdotal information on this board about the UB clinic. If it is as successful as they claim, you would think that word would get around.

That is precisely why I went. There seemed to be little here talking about the concussion clinic there. I figured if I went and documented it I could feel a little better about sitting on a couch for two months. Maybe it helped someone?

Unfortunately they did little to help me other than correctly diagnose me with a neck injury and tie my remaining symptoms to that injury. That was very valuable to me but did not leave me with an opportunity to try the full rehab program.

I was told to by Dr. Leddy at UofB to get a therapist who could work with upper cervical neck injuries, which is apparently easy to find. I of course only heard, "you won't have a setback if you do stuff." So I just started going right back into my routine.

Exercise resumed. I went back to work full time. Stopped taking elavil/amatryptyline. I still had problems sleeping, some minor vertigo in the mornings and headaches after working out, (definitely neck related, see ice pack remedy above). But knowing I could just ignore it all without making things worse made my life about 1000 times better.

I scheduled an appointment with my main doctor to tell him about my trip to buffalo and to help me find a therapist. By the time I got there two weeks later pretty much everything had cleared up except the sleeping. Which is now mostly normal unless I sleep with my neck in a bad position.

Interesting - did you have a good impression of the clinic staff? I'm guessing the answer is yes, since they helped correctly diagnose your injury.

Yes. There is a PT named Scott. He's seen hundreds of people and put them through the tests. To be honest, seeing someone with that much experience was pretty much worth the trip for me at least.

And Dr. Leddy seems competent. He had someone take my history and then give him a summary before he saw me and she got it wrong. So that was a bit annoying but didn't really have an impact on my visit.

The facilities are a bit old and out-dated, like a really old high school.

But overall it was a pleasant visit.

I can definitely relate. I’m also 27, and I’ve had nausea and dizziness since my concussion in January. It seemed to taper off for me around the beginning of June (so about six months) until I hit my head again and now I have it every day, along with headaches/migraines. My CT scans (spine and head) also came back fine and I’m also doing physical therapy, which helps with the headaches a little bit but not the dizziness or migraines. Good luck with your symptoms! I know how frustrating they can be!

Follow up from Dr.
 

The doctor told me that I could have dizziness and other post-concussive symptoms for up to 2-1/2 years.

He said that time is really the only thing that can heal it. Because I don't and have never had any vertigo, he doesn't think it's an inner ear thing, so he wouldn't refer me to an ENT. He did write a referral to a head injury clinic in Calgary to see another neurologist. However, he said that since I only had a mild head injury and that the clinic decides if it's worth seeing a referral, they may not even agree to see me.

Also, because I don't have any vertigo he doesn't think that the vestibular physiotherapy I've been doing will have any effect.

I asked him about osteopaths and craniosacral massage therapy and he thought it was a scam. He said there's no evidence that the cranial bones can move after you're 2 years old. He did say that the risk of side effects is pretty low. He said that some people will feel better, but it is a placebo. Anyway, I'll keep my osteopath appointment for this Thursday, since I've got $500 with benefits for it. But, at $100 a visit, it won't last long.

He mentioned that acupuncture might help, but that it's very likely it won't.

So, he said I can try physiotherapy, and craniosacral massage and acupuncture and somewhere along that line I might get better. But, if I do get better, he said it's probably more a result of time than any particular treatment or therapy.

I should hear from his office or the head injury clinic fairly soon about if I've got an appointment and when it is.

In the meantime, I'll start with the Osteopath and see where that goes.

The physiotherapist said to continue with the exercises until they are easy to do and then come in to see her again. I guess I'll do that and see where I am in a couple of weeks.

I had a mild TBI 2 years 2 months ago and one of my disabling symptoms is dizziness (weird vision, imbalance, jello legs at stores etc.,). Few symptoms you mentioned are interesting and I do have them. Dizzy at big stores (weak legs), dizzy at stop lights and turning head and walking/talking I get imbalance. It is not vertigo and one ENT doctor injected steroids (I think) in my ear, vestibular therapy, vision therapy, chiropractor, cranio sacral therapy etc., and nothing changed. I also have other terrible symptoms like fatigue, dull headaches, tinnitus, facial pain etc., and all of them are 24/7 and only during nights for some reason my symptoms goes down and I feel some what o.k.

Few things worked for me are Myofascial pain release and Xanax (low dosage). I don't take Xanax anymore since it stopped working at low dosage. I will be going to Vision Therapy again with a new therapist since my other specialist "thinks" it is from my vision.

I am not sure where your doctor came up with 2-1/2 years. No one can predict and you may recover in few months. But keep trying all the therapies out there including vestibular. You never know. I am still trying........................

Follow up from Osteopath
 

I went to the Osteopath yesterday and she started craniosacral therapy.

She said that I should come for 3-4 visits and then evaluate and see if it's making a difference.

I felt pretty dizzy after the appointment, but this morning, I'm back to my old dizzy self.

She said that she has had some success in treating PCS patients with craniosacral, but that it's different for every person.

In terms of actual symptoms that I do, and have been experiencing, I've really only had the dizziness. I had some headaches at first, but with a few back massages they seem to have really gone away. I've felt nausea at times in the past couple weeks, but I think that's more related to some of the more intense VRT exercises that I've been given.

Anyway, I'll continue with the osteopath and see where I am in a month.

Airmaster: You might consider going to a NORA certified optometrist for evaluation. Many of your symptoms can be attributed to "indirect optic nerve trauma" which is significantly different from "optic nerve damage". Dizzyness without actual vertigo, nausea, lightheadedness, headaches, panic-like response in crowds or stores, trouble reading, etc., can all be caused from indirect trauma to optic nerve. Vision therapy was a God-send for my daughter. She is doing very well (no headaches in a long time now) but I scan through this site occassionally for people who might benefit from vision therapy.

re dizzyness
 

Re the dizzyness, I am now into week 10 of my PCS and really felt that this was one of the worst symptoms having not felt anything similar and I kept slipping on my feet for quite a few weeks. Am posting to let you know that all of a sudden I have had a great week and the dizzyness is slowly going away. I no longer need a cold flannel on my head or neck most of the time! Nothing affected it more or less, but I did find it fairly dehabilitating. Just posting to say that I hope your symptoms lesson soon and hang in there, you might be only a few weeks away from a good one!:

I read on another thread about a person who was experiencing dizziness and was told it was related to their concussion. About 6 months after their concussion, they developed a bacterial throat infection and were prescribed Amoxicillin for it. Within a week all of their dizziness cleared up.

I have just completed a 10 day, 3 times-a-day prescription of Amoxicillin. Unfortunately, it did not make any difference for me. So, I guess I can rule out bacterial infection.

I have received a couple treatments of craniosacral therapy from an Osteopath. After the first treatment, I was quite dizzy for the next 4 or 5 days. Then, my dizziness returned to its baseline level. I had my second appointment just a few days ago and there has no been perceivable change, positive or negative. I only have enough $$$ in my employee benefits for 2 more visits. I think by then I should have a pretty good idea if there's any improvement by the craniosacral therapy.

Tomorrow evening I have an appointment with a new chiropractor who also practices acupuncture. My family doctor said that acupuncture may help with my dizziness, but that it also my have no effect. Has anyone had success with acupuncture?

The only symptom I'm experiencing is dizziness - lightheaded. Some days it is worse than others. I generally experience it the entire day, although if I'm sitting still watching TV, working on a computer or reading, I almost don't notice it. It seems worse in a busy mall or supermarket, and while I'm stopped at red lights while driving. (Although it immediately eases up once the car starts moving again).

I mentioned before I have same symptoms like yours when it comes to dizziness (non-vertigo) and it is the most debilitating symptom compared to others. I started Vision therapy once a week a month ago. Also changed my lenses in my glasses (five times in 2 years). Not sure anything is helping. But vision therapist said I have to do it for at least 6 months to see any benefit. I haven't tried Amoxicillin but I doubt it will work. I am going to ask my doc next time about that. Let us keep posted if anything works. BTW : I tried acupuncture and did nothing for me. You can give it a shot.

Hi PCSlife - have you seen any change in your symptoms since starting vision therapy?

I am going to look into vision therapy to see if it could help me.

I tried acupuncture back in August 2011. After 5-6 visits with no change whatsoever, it became clear that acupuncture wasn't going to do anything.

I have been doing NUCCA for about the past month - it's a type of chiropractic adjustment that only adjusts your C1 vetebrae/Atlas. It has made no difference whatsoever either.

I went back to my VRT physiotherapist at the beginning of Oct. 2011. She is puzzled as to what exactly I have since I am not responding to VRT. I have been doing the VRT exercises for the past week to see if it makes any difference. So, far, nothing outside of the normal up/down of my dizziness.

Has anyone experienced relief of symptoms with VRT? How long did it take before you experienced any changes? Did your dizziness go away completely with VRT?

Right now I am on the waiting list to see an ENT. However, the waiting list is 8-10 months long. I live in Alberta, Canada.

I am looking into options in the US to see an ENT sooner. Does anyone know of a good one in Montana? What is the typical cost to see an ENT?

Thanks.

Airmaster - I am not sure how much visual therapy is helping but I have completed 5 months (once a week). Lately I have discovering few things about my visual dizziness.

Few weeks I started wearing contacts which helps me. Also whenever I get dizziness (call it a shaky vision) I start wearing some prism lenses for few minutes which also helps. I cannot wear them all the time because everything looks elongated/tilted etc., These are just training lenses. I also use cheap short distance glasses when I wear contacts which also helps.

Malls/stores/restaurants are still a trouble but with contacts and cheap glasses it is manageable. I am thinking if I can go to Dr. Debby Feinberg she will be able to help me.
http://www.visionspecialistsofbirmingham.com/

I also have issues with noise (like fridge running, any vibrating noise) which makes me dizzy and gives me headaches too. I will be taking a CT scan of my ear soon to see if there are any structural problems.

My recommendation is to try vision therapy and see how it goes. With our conditions the only way to find out is to try.