• Qadeer Arshad
    Imperial College London
  • Ed Roberts
    Imperial College London
  • Hena Ahmad
    Imperial College London
  • Rhannon Lobo
    Imperial College London
  • Mitesh Patel
    Imperial College London
  • Tim Ham
    Imperial College London
  • David J Sharp
    Imperial College London
  • Barry Seemungal
    Imperial College LondonImperial College Healthcare NHS Trust
Abstract
Objective
We hypothesised that chronic vestibular symptoms (CVS) of imbalance and dizziness post-traumatic head injury (THI) may relate to: (i) the occurrence of multiple simultaneous vestibular diagnoses including both peripheral and central vestibular dysfunction in individual patients increasing the chance of missed diagnoses and suboptimal treatment; (ii) an impaired response to vestibular rehabilitation since the central mechanisms that mediate rehabilitation related brain plasticity may themselves be disrupted.
Methods
We report the results of a retrospective analysis of both the comprehensive clinical and vestibular laboratory testing of 20 consecutive THI patients with prominent and persisting vestibular symptoms still present at least 6 months post THI.
Results
Individual THI patients typically had multiple vestibular diagnoses and unique to this group of vestibular patients, often displayed both peripheral and central vestibular dysfunction. Despite expert neuro-otological management, at two years 20% of patients still had persisting vestibular symptoms.
Conclusion
In summary, chronic vestibular dysfunction in THI could relate to: (i) the presence of multiple vestibular diagnoses, increasing the risk of ‘missed’ vestibular diagnoses leading to persisting symptoms; (ii) the impact of brain trauma which may impair brain plasticity mediated repair mechanisms. Apart from alerting physicians to the potential for multiple vestibular diagnoses in THI, future work to identify the specific deficits in brain function mediating poor recovery from post-THI vestibular dysfunction could provide the rationale for developing new therapy for head injury patients whose vestibular symptoms are resistant to treatment.
Original languageEnglish
Pages (from-to)17-19
JournalClinical Neurology and Neurosurgery
Volume155
Early online date7 Feb 2017
Publication statusPublished - 1 Apr 2017
Externally publishedYes
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