Vestibular dysfunction following concussion is often subtle and lacks the classic signs that neurologists and ENT clinicians have come to depend on diagnostically. In concussion, the injury is at a cellular level, and the patterns of dysfunction are often similarly microscopic. In addition, concussion is a diffuse or global injury to the brain and so there is an interplay of dysfunction within the visual, auditory, vestibular and proprioceptive systems that normally contribute to asymptomatic vestibular function. The interaction of these different components of sensory input manifests as the function of the vestibular system.
Approximately 60% of Highmark’s concussion patient population presents with symptoms of dizziness, vertigo, unsteadiness, and/or nausea, any of which may be indicative of vestibular system dysfunction. In medical literature, the percentage is as high as 80% in some populations of patients. Vestibular therapy is an accepted rehabilitation modality in concussion and post concussion syndrome, and is increasingly utilized in the multidisciplinary clinics in which concussion is best treated.
At HighMark, we utilize traditional vestibular therapy and manoeuvres as well as employing technology and specifically virtual reality games and scenarios to provide precise, controlled targeted stimulation of the vestibular system. In the Highmark experience this approach has consistently demonstrated significant improvement in balance function as well as many other concussive symptoms.