Introduction
A 23-year-old female presented with Postural Orthostatic Tachycardia Syndrome (POTS) for the past 6 years. Her chief complaints were fatigue, tachycardia, pre-syncope, dizziness, pain and migraines.
Examination and Diagnosis
A neurological examination revealed ponto-medullary dysfunction.
Treatment
The patient was initially treated 2x per week for 1 hour over 7 consecutive weeks. Visits included neuromodulation therapy, vestibular rehabilitation, neuromodulation to the hypoglossal and trigeminal nerves, red/ NIR light therapy and tilt table therapy. In addition, the patient completed 20 hours of mild hyperbaric oxygen therapy over a 4-week period.
In the second round of treatment, the patient was seen 1x per week for 1 hour over 6 consecutive weeks. She continued tilt table therapy, orthostatic retraining, red/ NIR light therapy and started chiropractic adjustments, EMS muscle stimulation to the cervical spine and vibration therapy to the upper thoracic region.
The patient is currently on a maintenance treatment plan of chiropractic care and red/NIR light therapy. She will be seen 1x per week for 15 minutes and treatment will be tapered after 6 weeks.
Results
The patient has seen improvements in all symptoms. She has only had 1 migraine since beginning treatment 13 weeks ago. She went from having dizziness and tachycardia daily to now only noticing it every couple of weeks. She is able to shower without a shower stool, work 12 hours days with minimal fatigue and she is sleeping better.
Conclusion
Functional neurological care has been shown to be effective in the treatment of Postural Orthostatic Tachycardia Syndrome. Please visit our Dysautonomia Program page for more information.