We treat concussions and whiplash injuries

In the event of a concussion and post-commotio syndrome, the limbic system – the brain's emotional and survival center – can be significantly affected.

Concussion causes functional impairment in several areas responsible for limbic functions. Including areas called the amygdala, hippocampus, and prefrontal cortex , which are crucial for emotion regulation, stress response, memory and social behavior . This can lead to symptoms such as increased irritability, anxiety, depression, emotional instability, reduced motivation and stress intolerance . At the same time, the connections between the limbic system and the autonomic nervous system are affected, which can lead to disturbed sleep, inner unrest, hypersensitivity to sensory impressions and a reduced ability to regulate the body's physiological stress response . These functional disorders may explain why many with post-concussion syndrome experience that emotional, cognitive and physical complaints often reinforce each other and persist over time. Anxiety&Mood post-concussion syndrome is therefore characterized by increased anxiety, depression, mood swings and sleep problems.  

Just as there is no specific area of the brain that is responsible for performing a specific cognitive or executive task, there is no specific area that is solely responsible for a limbic reaction. But a complex and harmonious cooperation between several parts of the brain at the same time. Including the cerebellum which has important functions in coordinating and regulating emotional reactions, stress response and emotional learning.

In cognitive post-concussion syndrome, there are clear challenges with specific cognitive and executive functions. Among other things, concentration, processing and working memory. There is not a specific area in the brain that is responsible for performing a specific cognitive or executive task, but a complex and harmonious cooperation between several parts of the brain at the same time. Although there is no specific area that is solely responsible for a function, there are some specific areas in the brain that have more responsibility than others during certain actions. For example, fine motor movements are coordinated by the cerebellum, the cerebellum is also involved in coordinating the activity between the different parts of the brain that are involved in cognition and execution. The cerebellum ensures, among other things, the correct attention and pace in information processing, and contributes to accuracy and timing in mental processes.  

It is not only a well-coordinated, smooth and harmonious activity between the different parts of the brain responsible for cognition and execution that is necessary to have good cognitive and executive abilities. The brain and nervous system must also be able to collect, filter, process and coordinate different forms of sensory input simultaneously in an effortless and efficient way in order to produce good and effective cognitive and executive actions. So an injury or dysfunction in, for example, the vestibular system, which involves the production of movement signals in the balance organ in the inner ear and the transmission of these movement signals to the parts of the brain responsible for collecting, filtering, and processing these movement signals. And also at the same time coordinating this movement information with other parts of the brain responsible for balance and orientation. Will not only trigger symptoms such as dizziness and impaired balance, but can also cause challenges with cognitive and executive tasks.  

The development of post-traumatic migraine is most likely due to a stress reaction resulting from the above-mentioned functional disorders, which leads to disturbed regulation of the autonomic nervous system. This disturbed regulation of the autonomic nervous system triggers a chain reaction of further functional disorders.

• Prolonged contraction of blood vessels (vasoconstriction) after stress or strain.

• A reflexive widening of blood vessels (vasodilation).

• Overactivation of centers in the brainstem involved in sensitivity to the face, the trigeminal nerve, which releases the neuropeptide CGRP and creates inflammation around the brain's blood vessels in addition to facial pain.

• Reduced attenuation of the parasympathetic nervous system, which means that blood vessels and inflammation do not calm down, which prolongs the migraine attack.

• Disturbed baroreflex that regulates blood pressure when the body changes position, which causes blood pressure fluctuations, dizziness and headache sensitivity.

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Because the uncontrolled contractions and dilations of blood vessels can affect any part of the brain and brainstem, there is also a wide range of symptoms that migraines can cause. The most common and well-known symptoms include:

• Headache.

• Dizziness.

• Stiffness and pain in the neck.  

• Sound and light shadow.

• Nausea.

• Visual disturbances.  

• Exhaustion.  

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But migraines can also affect other parts of the brain and brainstem, leading to more unfamiliar symptoms:

• Loss of vision in part or the entire field of vision.

• Language difficulties or loss of language.

• Stomach pain and diarrhea.  

• Muscle spasms.

• Muscle paralysis

• Impaired balance.

• Faint.  

Neck pain after a concussion is very common, and as mentioned earlier, the mechanism of injury is the same for a concussion as for a whiplash injury. However, it is only in a third of cases of whiplash that structural damage to the neck can be seen. Several professional communities therefore suspect that chronic neck pain and the accompanying neck-related pain are due to complex dysfunctions in the parts of the brain and nervous system that are involved, among other things, in the control of stabilizing muscles and the large muscles of the back and neck. This includes parts of the brain and nervous system that are involved in filtering, recognizing, processing and coordinating movement information from joints and muscles in the neck and jaw joints, movement information from the balance organ in the inner ear, visual movement information, and movement information from joints and muscles from the body, arms and legs. To filter, recognize, process and coordinate different movement information properly and effortlessly. The brain must also have good abilities to activate and communicate with the different areas of the brain and nervous system that are involved in activating and controlling the core muscles of the neck and the muscles that control conscious movement of the neck to function normally. This includes, in addition to the areas of the brain that receive the different types of movement information, areas that are directly involved in, among other things:

• Send activation signals to the muscles in the neck and jaw joint.

• Coordinate muscle movements with the neck and jaw joints.

• Coordinate muscle movements in the neck with muscle movements of the eyes.  

• Balance and the ability to walk and move the head and neck while standing still or in motion.      

In concussion and post-concussion syndrome, one or more functional disorders in this complex circuit result in poor control of core muscles, increased static muscle tone in the neck and jaw joints, impaired ability to recognize neck movements, impaired control of the bite reflex, and impaired ability to coordinate and process movement information from other parts of the sensory system. The classic symptoms of these functional disorders are:  

• Stiffness and pain in the neck and jaw joint.

• Weakness and poor tolerance to neck movement.  

• Tension headache.

• Dizziness.

Oculomotor post-concussion syndrome involves dysfunction in parts of the brain and nervous system that are involved in controlling and coordinating purposeful and reflexive eye movements. From centers in the brainstem that are involved in keeping the gaze fixed on an object, to centers in the brain that are involved in concentration, responsiveness, and coordination. Dysfunction in one or more areas that are involved in controlling and coordinating eye movements not only leads to visual disturbances in the form of blurred or double vision, and discomfort when reading and using screens. One can also experience impaired concentration, reading and learning difficulties, brain fog and dizziness, dizziness, and difficulty with tasks that involve the gaze.

Vestibular post-concussion syndrome involves dysfunction in the filtering, processing, and integration of motion signals from the balance organ in the inner ear. This also involves integration of motion information from the muscles and joints in the neck along with fine motor control and coordination of reflexive eye movements. This involves the ability to filter and recognize head movement, which is important for distinguishing whether you are moving or standing still, and the ability to maintain gaze stability on an object while the head and neck are moving through the vestibulo-ocular reflex (VOR) and cervico-ocular reflex (COR), which are important for maintaining gaze stability when moving or reading. Good function of the VOR and COR is also essential for good visual and physical orientation when you are moving. Dysfunction of the vestibular system leads to:

• Dizziness.

• Unsteadiness and impaired balance.

• Challenges with focusing the gaze.

• Challenges with visual orientation during movement.