Case Study: Dysautonomia: 30-Year-Old Female

A 30 year-old female presented to CFNC reporting syncope, dizziness, tachycardia, heat intolerance, fatigue, exercise intolerance and brain fog. Her biggest goals for treatment included being able to get back to exercising and take long walks as well as regain the ability to take care of her home and children without feeling ill. 

Examination 

Upon examination we found irregular heart rate changes with an orthostatic challenge of supine to standing, asymmetric facial sensation, functional differences in tongue and eye lid strength, difficulty with eye movements in the vertical plane, and mildly reduced balance scores on computerized posturography.

This patient was diagnosed with Dysautonomia based upon her medical history and thorough examination. Furthermore, her examination identified dysfunction in two key parts of her brainstem, the Midbrain and the Pontomedullary Reticular Formation (PMRF).

Treatment

The patient was seen twice a week for five weeks. Her treatment consisted of autonomic retraining, vestibular rehabilitation, oculomotor therapy, peripheral nerve stimulation, vagal nerve stimulation, Bemer therapy, red and near infrared light therapy, and gentle chiropractic adjustments as needed. 

Results

At re-examination, the patient reported improvement in exercise intolerance, tachycardia, dizziness, fatigue, syncope, and brain fog. She also noted that the orthostatic components (the ups and downs) of household chores were significantly less demanding. 

Objectively, the patient demonstrated improved exercise capacity, evidenced by her ability to complete exercise programs with her trainer that had previously caused her to faint. An orthostatic vital assessment revealed a heart rate increase from 73 bpm supine (lying down) to 101 bpm standing; however, the increase no longer sustained.

In addition, balance scores, eye tracking, facial sensation, and facial motor output all showed measurable improvement into normal ranges.

The patient was able to meet her treatment goals and resume her prior activities of daily living without significant symptomatology.

Conclusion

Patients of all ages and life stages can benefit from individualized neurological rehabilitation. In this case, treatment was tailored to a new mother experiencing multiple dysautonomia-related symptoms, including syncope, dizziness, tachycardia, heat intolerance, fatigue, exercise intolerance, and brain fog. While many patients may present with similar symptoms or diagnoses, this case highlights the importance of personalized care in achieving meaningful outcomes that contribute to improved quality of life.

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