Visual disturbance, dizziness, headaches and other neurological complaints after concussion due to convergence excess/spasm.

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February 19, 2021

I recently evaluated a patient whose diagnosis was post-concussion syndrome, which affects 20-30% (number varies) of individuals after their initial concussion causing prolonged symptoms. She came in with many complaints after experiencing multiple concussions - daily headaches behind her eyes that would often radiate to her temples on both sides, jumpy/double vision, difficulty riding in a vehicle as a passenger, nausea, light and sound sensitivity and brain fog. And, despite all of those different symptoms, there was one main issue related to most or all of them, and that was convergence spasm. 

Convergence spasm occurs when there is overactivity in an area of the brain called the mesencephalon (top part of the brain stem). As a result, the convergence centers are not inhibited well and excessively respond to near targeting, causing the eyes to spasm and beat uncontrollably. When this occurs a patient may notice dizziness, headache, imbalance, visual scene motion due to eyes bobbing/moving (oscillopsia) and nausea that occurs during normal daily activities. Difficulties that occur after riding in a vehicle, reading, computer work, busy environments, following a moving target and self-motion are not uncommon.  This is often very uncomfortable and relates to many of the symptoms experienced after a concussion. 

For the patient I was describing earlier, after evaluating her, we were able to detect abnormalities of signaling within mesencaphalon as we would expect. When we performed neurologist therapies in a certain way to specifically activate neuropathways related to her condition, we were able to reduce her convergence spasm and she was able to tolerate many of the tests that were previously intolerable. Convergence spasm after a concussion or during post-concussion syndrome is treatable and should be evaluated by someone who specializes in the area, such as a Chiropractic Neurologist. As an aside, I often see ocular flutter in relation to convergence spasm with patients that I see, which resolves once the convergence spasm has been adequately treated. 

At Portland Chiropractic Neurology, located in Portland, Maine, we are specialize in concussion, post-concussion syndrome and also vestibular rehabilitation that often result in oculomotor disturbance as seen with convergence spasm. This is very treatable and if you've experienced a concussion or mild tramautic brain injury, I would implore you to consider getting an evaluation by a Chiropractic Neurologist who specializes in these conditions. Please contact us if you are in need of help or have further questions.