Case Study: Vestibular Dysfunction: 68-Year-Old Female

A 68-year old female presented to the York, ME office with main complaints of brain fog (consisting of fatigue, memory issues, and trouble with numbers), vertigo, and lack of appetite. Symptoms had been progressing for 2 years, and she had unofficially been given a diagnosis of POTS. Patient reported heart rate spikes as high as 130bpm without any physical activity, unsteadiness while moving around causing her to be confined to her recliner often, and an inability to balance her checkbook.

Examination

Functional neurological examination revealed widespread dysfunction within the right vestibular system along with oculomotor dysfunction. A complete metabolic assessment also revealed blood sugar dysregulation. 

Treatment

An acute round of treatment was recommended, consisting of 12 functional neurological treatments and 10 hours of mild hyperbaric oxygen therapy. Dietary strategies to address blood sugar regulation were also discussed and implemented.

Results

After one acute round of treatment, this patient reported an 80% improvement in her symptoms. She is now walking 10,000 steps per day, her appetite has returned to normal, she is able to once again balance her checkbook with ease, and she reports that the incidence of random heart rate spikes has decreased drastically. 

Conclusion

A thorough functional neurological examination is vital in determining the root cause of complicated and chronic symptoms, as described above. This patient had received a diagnosis of POTS, but a functional examination pointed to vestibular dysfunction as the primary cause of her symptoms. Once properly addressed, her symptoms decreased and her quality of life improved drastically.