Neurosensory Symptom Complex after mTBI

8/17/2019 Neurosensory Symptom Complex after mTBI

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Neurosensory SymptomComplexes after AcuteMild Traumatic BrainInjury*

Isma Resti Pratiwi Jenny Ismyati

*Michael E. Hofer, Mikhaylo Szczupak, le!an"er #i"erman, James $raw%or", SaraMurphy, #athryn Marshall, $onstanza Pelusso, $arey &ala'an

PLOS ON ! "OI#$%&$'($)journal&pone&%$+%', -anuary . /%$+


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Intro"uction

MildTraumatic

Brain Injury0mTBI1#

pu2lic 3ealt3issue. 3i43pre5alencein sport and

military

Su2jecti5esymptoms

remains asdia4nosticand

treatmentapproac3

T3is study

"esccri2in4and 6ualifyin4

t3ecomplaints in

mTBI

compared tocontrol


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Materials an" Metho"s

()es +-(Ha" a "ia)nosis o% m/&I(0ithin si! "ays o% in1uryin%orme" consent stan"ar" assesment


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Detailedmedical historyand physicalexamination

Investigator-administeredsymptomquestionnaire

DizzinessHandicapInventory(DHI) 25questions(alwayssometimesnever)

!rail "a#ing!ests $ and %

&unctional 'ait $ssessment

otationalchair testattery *or

oculomotorand vestiularre*lexper*ormance+


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Result

( /otal stu"y population 2 3m4% 5 6,78 49+,68:

m/&I $ontrol

Stu"y population 7% $%%

Mean a)e /+.+ /,.

;era)e time /./ days post concussion


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Mean ratin)so% symptoms%or the control)roup wereall less than2. re%ersto


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• 9 6 ? 2 o % t h e m / & I ) r o u p h a " @ H I s c o r e s o % a t l e a s t 7 2 , i n " i c a t i n ) ) r e a t e r t h a n m i l " i m p a i r m e n t , w i t h a n o t h e r + s u ' 1 e c t s i n t h e m i l " r a n ) e 3 ' e t w e e n * A a n " 7 2 : .

• B i n e o % t h e 2 s u ' 1 e c t s w i t h m / & I w e r e w i t h i n n o r m a l l i m i t s o n a l l t h r e e o % t h e s e s y m p t o m m e t r i c s 3 @ H I , / M / ? / M / & a n " C D :

• / h e @ i z z i n e s s ? M i l " $ o ) n i t i ; e I m p a i r m e n t c l u s t e r s c o r e i n t h e m / & I ) r o u p s h o w e " a s i 4 n i 8 c a n t p o s i t i 5 e c o r r e l a t i o n 9 i t 3 t 3 e t o t a l " : I s c o r e 3 r 5 2 . A , p 2 . 2 2 * : , a s w e l l a s t h e % u n c t i o n a l 3 r 5 2 . A F , p 2 . 2 2 * : , p h y s i c a l 3 r 5 2 . - + , p 2 . 2 : a n " e m o t i o n a l 3 r 5 2 . F , p 2 . 2 2 * :

• B e i t h e r t h e / M / , t h e / M / & n o r t h e C D s c o r e s w e r e c o r r e l a t e " s i ) n i G c a n t l y w i t h a n y s y m p t o m c l u s t e r s c o r e .


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@iscussion

* • I n " i ; i " u a l s y m p t o m s s e ; e r i t y " i f e r e n c e ' e t w e e n m / & I a n " c o n t r o l i s e ! p e c t e " d o n o t d i ; e r 9 i t 3 p r e 5 i o u s s t u d y

9

• @ i z z i n e s s ? M i l " $ o ) n i t i ; e I m p a i r m e n t r e


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@iscussion

* • M a l e s a n " % e m a l e s u s e d i ; e r e n t s y m p t o m d e s c r i p t i o n s f o r s i m i l a r u n d e r l y i n 4 c o n d i t i o n s , o r t h e r e m a y ' e d i ; e r e n t p a t t e r n s o f i n j u r y i n m a l e s a n " % e m a l e s .

9 • " i = = i n e s s a n d c o 4 n i t i 5 e f u n c t i o n , a s m e a s u r e d ' y o c c u l o m o t o r , r e a c t i o n t i m e , a n " ; e s t i ' u l a r t e s t s w i t h i n % r a r e "

) o ) ) l e s , c a n p r o 5 i d e n e a r l y , % > s p e c i 8 c i t y a n d s e n s i t i 5 i t y % r o m " i s t i n ) u i s h i n ) m / & I % r o m c o n t r o l s .

7 • M e a s u r i n 4 d i = = i n e s s a n d c o 4 n i t i 5 e i s s u e s i s f a r m o r e

a c c u r a t e t h a n i n u i r i n ) a ' o u t t h e s e s y m p t o m s .

- • 0 e n e e " t o c 3 a r a c t e r i = e ' e t t e r w a y s o % e l i c i t i n ) a h i s t o r y o %

" i z z i n e s s o r c o ) n i t i ; e i s s u e s a n d 2 r i n 4 d e 5 i c e s t 3 a t c a n m e a s u r e t 3 e s e s y m p t o m s t o t h e p o i n t o % i n 1 u r y o r " i a ) n o s i s .


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$onclusion

:eadac3e.di==iness. and

co4niti5e"ys%unction

more common inm/&I

Symptomse!perience" a%teran m/&I remainone of t3e most

important toolsin t3e dia4nosis an" tre atment o%

this "isor"er

%airly simple seto% uestions

inuirin) a'out"izziness,

hea"ache, an"

co)niti;e issues pro5ide

dia4nostic 2utnot pro4nosticand treatment

plannin4


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T3an?s@Any 6uestions

Neurosensory Symptom Complex after mTBI

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