Case Study on the Autonomic Nervous System: Kate

If you’re looking for an interesting individual case study on the autonomic nervous system and all the problems it can cause, you’re in the right spot. This often overlooked system can be at the heart of many chronic conditions. We see a lot of concussion, migraine, and dizziness cases, but it can be at the root of so much more. We’ll cover a specific patient, review their findings, and ultimately examine how we influenced the autonomic nervous system to mitigate symptoms and give this patient their life back. This article serves as a case study on the autonomic nervous system.

Before diving into this fascinating case, let’s cover the basics of the autonomic nervous system and what it does.

   The Autonomic System

The autonomic nervous system (ANS) is a fascinating central nervous system (CNS) branch. The easy way to understand it is it controls all the “automatic” functions like heart rate, digestion, and blood pressure. It has two branches: the sympathetic (fight or flight) and the parasympathetic (rest and digest). It is the stress response system and the calm-down system.

When one or both of these branches malfunctions, bad things happen. For example, when the sympathetic nervous system ramps up for too long, you get things like anxiety, burnout, and chronic immune problems. You can also get the same symptoms when the parasympathetic system can’t perform.

On the other side of the coin, if the stress system can’t do enough, you get symptoms like chronic fatigue, syncope, and hypoprofusion.

The bottom line is the autonomic systems need to be balanced for the person to be healthy. The following case study will examine what happens when these imbalances appear in real life.

Note: The patient has approved the following information. Her name has been changed for anonymity, and both parties have approved all the details of her case in writing.

 Kate: Post Whiplash Autonomic Issues

A 49-year-old woman named Kate came into the clinic complaining of ongoing fatigue, dizziness, head pressure, and episodes of syncope (fainting). This was all following a car accident 6 months prior. She had gotten several months of PT and chiropractic following the accident. She had also had a consult at a vision clinic and had several blood panels run. The blood panels showed a slight elevation in white blood cells, which usually means some infection at a fundamental level.

Her testing revealed some significant things relevant to her autonomic issues.
1: A vestibular finding called nystagmus was happening in the vertical plane. This means when her eyes are covered up, they drift up and then correct back to center.
2: Her heart rate went up 39 beats, and she stayed there when she went from sitting to standing.
3: Her neck was still severely whiplashed, and she did not give appropriate feedback. This information was gathered through something called the cervical proprioception test.
4: She had developed SIBO (small intestinal bacterial overgrowth).

Before we go into what we did, let’s back up and explain why these findings are relevant to the autonomic system. Her symptoms of fatigue, head pressure, and syncope are all autonomic. The fatigue is coming from her “fight or flight” system from being revved up too high. The head pressure comes from her elevated heart rate when she is standing. Her fainting episodes result from a failure of her autonomic system to deliver blood to her brain while she’s standing continuously. Our exam aims to find all possible sources of autonomic strain and remove them. The following is what we did.

   Treatment

In short, we took two separate approaches to fixing Kate’s autonomic issues.
1: We fixed the discrepancies between her vestibular system and her neck.
2: We addressed the stomach infection known as SIBO.

  Neck and Vesitublar Findings

To fix this aspect of her autonomic findings, we needed to address each issue separately and then tie them together.

When you have vestibular findings like hers, you feel almost constant motion sickness. One system tells her brain that she is moving forward and backward, but the rest of her systems do not say the same thing. If you’ve ever been seasick, you know it’s uncomfortable. It immediately affects your heart rate, digestion, and overall autonomic health.

To do so, we performed an increasingly tricky series of core exercises, vestibular exercises, and activities to support a brain region called the cerebellum. After three weeks of this program, her “nystagmus,” or vestibular imbalance, had cleared up.

While we were doing this, we simultaneously addressed the whiplash issues in her neck. Traditional medicine is great at improving mobility, alignment, and strength. It’s not so great at promoting good feedback, which is often the issue in whiplash.

To address this issue, we performed a series of neck exercises with a laser for visual feedback. This visual feedback allows the brain to identify where the signal breaks down. Once you know where the signal breaks down, you can train that specific area and quickly improve the neck feedback quality.

Once we individually addressed her neck and vestibular findings, we added exercises that used both systems together, and viola. After three weeks of care, her heart rate only went up 25 points during the same test, and she stopped having fainting episodes.

Stomach Care

This was a great outcome, but more was needed. The back half of her care involved lab testing, a stool sample, and some dietary changes.

In short, we put her on a stomach repair protocol, which involves taking a few months of supplements to repair the stomach and an elimination diet.

An elimination diet is a prolonged period of time during which you eat a very restricted diet, followed by a period during which you introduce individual foods one by one. This process allows you to see and feel how different foods affect your health, as the reaction to them is very strong after a prolonged period of abstinence.

One thing to note is that when she got into the accident, she started taking a very high dose of probiotics. She had heard it could benefit her recovery, so she started taking 3x the recommended dose. This led to an imbalance in her intestinal flora, which contributed to her SIBO and autonomic symptoms.

Part of her treatment involved identifying the specific strains of probiotics she needed to normalize her intestinal flora and minimize her autonomic symptoms.

After 3 months of this protocol, her autonomic symptoms were essentially gone. She had no head pressure, no fainting, minimal fatigue, and no dizziness since treatment.

    Summary

This is a classic case study of the autonomic nervous system as it pertains to concussion. So often, we hope to find a single source for the issue at hand. So often, it ends up being a combination of variables that add up to cause a bigger issue.

In this case, her vestibular/inner ear findings were causing her to feel motion sick nearly all the time. This, by itself, caused some heart rate and fatigue issues.

Her neck was not sending good feedback into her brain, so the brain was having difficulty matching that input up with the rest of it. This was further contributing to fatigue, head pressure, and fainting.

Add on SIBO, which acts like a slow drip of inflammation, and the autonomic system gets overwhelmed to the point where it can’t manage all of the stress. That’s when you get things like fainting and chronic fatigue.

If you have questions about hearing after a concussion, click here to schedule a complimentary consultation with one of our doctors. We’ve treated hundreds of complex neurologic cases and can help piece together the missing pieces in your recovery.

*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any remedies or therapies at home.