Treatment of vertical heterophoria ameliorates persistent post-concussive symptoms: A retrospective analysis utilizing a multi-faceted assessment battery

Rosner, Mark; Feinberg, Debby; Doble, Jennifer E.; Rosner, Arthur J.

doi:10.3109/02699052.2015.1113564

Cited by 21 publications

(11 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two longitudinal prospective studies [31,32] found that IV metoclopramide 20 mg plus diphenhydramine 25 mg was effective and well tolerated in acute PTH subjects, while the interdisciplinary outpatient treatment of chronic headache subjects abnormally reduced the individual mean pain throughout the previous 7 days, together with actual pain severity (with a general maintenance of results at one-year follow-up). Moreover, according to four retrospective studies in this field [33][34][35], the multidisciplinary treatment approach was associated with reduced self-reported PTSD and persistent post-concussive symptoms (PPCSs), a relevant reduction in persistent post-concussive anxiety, dizziness, and headache was linked to identifying/correcting the visual misalignment with neutralizing prismatic lenses, and onabotulinum toxin A may represent a valid PPTH preventive strategy in subjects at risk for cognitive, metabolic, or behavioral adverse effects related to standard treatments. Furthermore, based on two cross-sectional studies [36,37], repetitive transcranial magnetic resonance (rTMS) influences headache severity, frequency, functional outcomes, symptoms of post-concussion, depression, and quality of life in PPTH subjects and patients with PPCSs, and rTMS was linked to a reduced severity in PPCSs and an enhanced activation of the dorso-lateral prefrontal cortex.…”

Section: Included Studies About Currently Available Treatments For Ppthmentioning

confidence: 99%

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

Guglielmetti

Serafini

Amore

et al. 2020

IJERPH

View full text Add to dashboard Cite

Post-traumatic headache (PTH) may be considered a secondary headache, which is linked to severe disability and psychosocial impairment. Interestingly, nearly 30% of subjects with persistent post-traumatic headache (PPTH) also suffer from post-traumatic stress disorder (PTSD). Although existing studies demonstrated the existence of common pathophysiological characteristics in subjects with migraine and PPTH, the differences and similarities between these complex diseases are currently poorly understood and are yet to be comprehensively elucidated. Thus, the present review aimed to systematically investigate the nature of PPTH in the effort to better identify both the neurobiological and clinical aspects underlying this condition. Overall, the included studies reported that: (1) the predictors for persistent acute traumatic injury to the head were female gender, persistent symptoms related to mild post-traumatic brain injury (mTBI), PTSD, elevated inflammatory markers, prior mild traumatic brain injury, being injured while suffering from alcohol abuse; (2) static/dynamic functional connectivity differences, white matter tract abnormalities, and morphology changes were found between PPTH and migraine in brain regions involved in pain processing; and (3) clinical differences which were most prominent at early time points when they were linked to the increased risk of PPTH. Based on the selected reports, the relation between migraine and PPTH needs to be considered bidirectionally, but PTSD may play a critical role in this relation. The main implications of these findings, with a specific focus on PTSD, are discussed. Further longitudinal studies are needed to reveal the exact nature of this relation, as well as to clarify the distinct clinical characteristics of migraine, PPTH, and PTSD.

show abstract

Section: Included Studies About Currently Available Treatments For Ppthmentioning

confidence: 99%

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

Guglielmetti

Serafini

Amore

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…Specifically, an asymmetric counter-rolling effect from abnormal utricular stimulation can cause BVD. [8] Treatment for BVD typically employs the use of microprism lenses to ameliorate the visual misalignment [2]. The patients in this study were all post-concussive and all reported significant improvement with microprism lenses.…”

Section: Discussionmentioning

confidence: 95%

“…VH treated with microprism lenses affords significant improvement in the symptoms of dizziness. [1][2][3] In 2016, one of the authors observed in their clinical practice that in those with VH who had residual dizziness despite treatment with microprism lenses, hyperacusis was frequently experienced, and that utilization of noise cancelling devices (NCDs) led to further reduction of dizziness, improvement in balance and gait stability [4]. Additionally, an improved ability to obtain an accurate binocular alignment vision prescription (accomplished with microprism lenses) was afforded patients using NCDs.…”

Section: Introductionmentioning

confidence: 99%

Association Between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device (NCD): Inverse Tullio Phenomena

Feinberg¹,

Rosner²,

Gianoli³

2023

Preprint

View full text Add to dashboard Cite

Identifying a vestibular source of pathology in patients complaining of post-traumatic brain injury (TBI) dizziness can be difficult. We describe a possible new method utilizing the reduction of post-TBI symptom (including dizziness) with the use of a noise cancellation device (NCD). This retrospective case series included patients with TBI and dizziness presenting to a binocular vision specialty clinic, who were diagnosed with a vertical heterophoria (VH). If they did not respond adequately to microprism lenses and/or if they experienced hyperacusis, they were evaluated with an NCD. If there was marked reduction of TBI symptoms (including dizziness), the patients were referred to a neuro-otologist for vestibular diagnostic evaluation and treatment. Fourteen patients were identified and found to have abnormalities on vestibular testing consistent with Third Mobile Window Disorder (TMWD). All were treated with a 6-week medical protocol (diuretics, no straining, low sodium/no caffeine diet). Five responded positively, requiring no further treatment. Nine required surgical intervention and responded positively. In conclusion, 14 patients with post-concussive dizziness and VH, a positive response to NCD was associated with abnormal vestibular testing, a diagnosis of TMWD, and symptom reduction/resolution with a medical or surgical approach. The removal of sound resulting in reduction or resolution of vestibular symptoms represents an Inverse Tullio Phenomena.

show abstract

“…Existing studies have circular logic: the diagnosis of the syndrome was based on subjective report of benefit from the prism during an assessment, and these subjects were then evaluated later with a questionnaire about benefit when wearing the prism. 21 None reported a placebo intervention or a control group.…”

Section: Prismsmentioning

confidence: 99%

“…21 The otoliths are vulnerable to head trauma, 22 and proponents of this syndrome assert that it is responsible for symptoms ranging from blur, diplopia, and dizziness to anxiety, headache, light sensitivity, and feeling overwhelmed in crowds. 21 However, such broad symptoms are not typical in subjects with nontraumatic otolithic dysfunction. 23 Furthermore, there is no evidence that these mTBI symptoms correlate with signs of otolith damage with vestibular testing.…”

Section: Visual Diagnoses In Mtbimentioning

confidence: 99%

Consensus Statement on Visual Rehabilitation in Mild Traumatic Brain Injury

et al. 2022

View full text Add to dashboard Cite

Optometric visual rehabilitation therapy has been employed for a variety of visual disorders. Descriptively-named entities such as post trauma visual syndrome (PTVS), visual midline shift syndrome (VMSS), and vertical heterophoria syndrome (VHS) are frequently diagnosed by neuro-optometrists and/or behavioral optometrist in patients after stroke or head injury or in the setting of dizziness and/or headache. The scientific underpinnings of these diagnoses and treatments are weak, and published clinical studies comprise case reports and case series without comparison to control populations. Neuro-ophthalmologists are frequently questioned by patients about the utility of such treatment strategies. Many ophthalmologists and neurologists also are involved in the care of patients who carry these diagnoses and undergo these visual therapies. Involved physicians may benefit from guidance about the rationale, evidence, and level of evidence for the efficacy of these therapeutic approaches.

show abstract

Treatment of vertical heterophoria ameliorates persistent post-concussive symptoms: A retrospective analysis utilizing a multi-faceted assessment battery

Abstract: Neutralizing prismatic lenses are an effective treatment of headache, dizziness and anxiety in patients with persistent post-concussive symptoms and VH.

Cited by 21 publications

References 12 publications

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences

Association Between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device (NCD): Inverse Tullio Phenomena

Consensus Statement on Visual Rehabilitation in Mild Traumatic Brain Injury

Contact Info

Product

Resources

About