One of the common questions patients with concussions ask is, “How will I know when I am all better from this concussion?”
Patients that received a head injury 10 years ago may still be suffering from neurological deficits as a result of that injury. They want to know why they are still having issues…”when that injury happened so long ago. Why am I not better?”
How can you validate their concerns and show them how their nervous system is still not functioning at 100%.
Let me introduce what I refer to as …’THE GOLD STANDARD’ for quick concussion evaluation.
I check the patient’s ability to rotate their neck pain free before proceeding. Then I ask them to perform 2 quick rotations and return to neutral. I want to look at their eyes and observe for any nystagmus (eye twitching), balance disorder and/or symptom aggravation.
Usually the patient will describe a sense of light-headedness and/or slight balance challenges. This is the result of disturbance of the inner ear, vision and cerebellum reflexes. When neurological deficits are present there will be dysfunction.
The reason the patient is still suffering (after possibly many years) is their nervous system has excess tension altering function.
THE GOOD NEWS…these patients can improve and the nerve deficits can be corrected.
A second concussion evaluation tool that is quick and can reveal nerve dysfunction is the CONVERGENCE DEFICIENCY exam.
Convergence is evaluated by having the patient watch the clinician’s fingertip while it is moving slowly toward the bridge of the nose from about 60 centimeters away. The normal reaction is turning the eyes inward to focus at close range.
Errors include the inability to perform the task accurately, nystagmus, and/or the aggravation of symptoms. Closely watch the eyes during this exam to see if one reacts differently than the other.
ANY DEVIATION indicates the possibility of neurological deficit. Confirm with the patient any challenges they experienced while performing the exam.
FREE Download – of my detailed Visual Error Scoring System exam sheet.
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