Assessment, Testing & Treatment for Post-Concussion Syndrome (PCS)

Do you want to learn more about what is involved in assessment, testing, and treatment for post-concussion syndrome (PCS) at Northoak?

If you are reading this post, it is likely that you or someone you care about has had a concussion and could currently be suffering from post-concussion syndrome. You may recognize some of the common PCS symptoms mentioned in other articles on our site.

While every case is different and it is impossible to go over each treatment scenario, our overall approach to PCS treatment does use the same basic framework for each of our patients.

In the eighth and final video in our Post-Concussion Syndrome series, we will explain what a typical PCS patient will experience through the initial consultation, neurological exam, diagnostic testing, report of findings, and treatment at Northoak Chiropractic:

If you have any questions about PCS treatment after reading this article, please send us a message.

Initial Consultation

At Northoak, most potential new patients will contact us directly through our website. Dr. Jay will usually have a short email exchange with you to learn more about the details of your case. If he thinks he will be able to help you, he will book an in-person consultation at our office.

Prior to the consultation, we will ask you to complete and return some preliminary health history paperwork, so that we can familiarize ourselves with your case before we meet. The paperwork is available for download from our website or we can email it directly to you when the consultation appointment is made.

At the consultation, we will discuss the details of your injury and symptoms to begin to narrow down which areas of the brain may be involved. Dr. Jay may do a couple of tests that are pertinent to your symptoms to see if it makes sense to proceed will the full examination. If he thinks we will be able to help, we will book an appointment for the neurological exam and diagnostic testing.

Neurological Exam & Diagnostic Testing

During the neurological examination, we will assess the overall function of your autonomic nervous system. We will also do additional testing of different areas of the brain, the sensory systems, and the motor systems relevant to the symptoms you are experiencing.

At Northoak, we use a lot of eye function tests to assess brain function. Vision is the only sense that uses almost all the areas of the brain in one way or another. Since different visual tasks use specific pathways and areas of the brain, they can be very useful to determine which regions of the brain are injured.

During the diagnostic testing session, we use videonystagmography to test how well your eyes hold, track, and capture both still and moving targets at different speeds and directions. If applicable, various balance tests will also be performed at this visit using force plate posturography.

Disclaimer: Most PCS patients will find this testing very tiring since weak and injured areas of the brain are being challenged. For this reason, we recommend that you have someone else drive you to and from this appointment.

Report of Findings

Once your neurological exam and diagnostic testing are complete, we will set an appointment for the report of findings. At this session, we will take half an hour to go over the detailed findings of the exam and diagnostic testing.

We will also outline a potential treatment plan for you, based on your specific injuries and the symptoms that you are displaying.

Your Treatment Plan

At Northoak, your treatment plan is designed to drive neuroplasticity in the injured neural pathways identified in your exam and diagnostic testing. Over the course of your treatment, we will also recommend diet changes intended to reduce inflammation in the brain and provide the nutritional building blocks for the formation of new neural connections.

To drive plasticity, your injured pathways will need to be used. We will start by activating them gently and indirectly at first, as it is important to keep tabs on your energy levels as we go. Each exercise and stimulation can only be done within the capacity of your injury.

As you improve over time and subsequent sessions, these activities will progress in intensity and duration. Typically, after 12 sessions we will rerun the exam and diagnostic testing to document progress. Most patients will be feeling improvement by this point and may decide to finish or continue treatment as appropriate.

A Typical Session

A typical treatment session for our patients will last a little over an hour. During that time, we will perform active exercises that are specific to you (the patient), your injuries, and your capacities.

These exercises may include:

  • Simple eye movements
  • Combined eye and head or body movements
  • Electrical stimulations of the tongue and face
  • Brain-based exercises, specific to the pathways involved
  • Rhythmicity and timing drills
  • Specific vestibular and balance stimulations
  • Vagal stimulations
  • Stop/start visual tasks
  • And more

Over the course of each session, we will keep track of how many repetitions of each stimulation or exercise you can tolerate. At the end of the session, you will have homework to do before our next session.

If our approach to treatment sounds like something that has been missing in your recovery, then give us a call or reach out to start the conversation. We are here to help!

Man with post concussion syndrome caused by whiplash in car accidentWoman suffering from chronic migraines with auras