Case History
 
Treatment of severe depression following head injury:
case presentation.
 
History:
 
22 yo male presented for treatment of severe depression and anxiety, lasting at least 3 years, following significant head injury.
 
His initial head injury occurred at age 6, when he fell off a bicycle, and had amnesia for the events of that day. He sustained a subsequent injury at age 16 while skateboarding, and suffered intermittent loss of  consciousness for about 2 hours. He sustained a third injury at age 19, in a roll-over car accident. He struck his head on the ground several times as the car rolled, but had no significant loss of consciousness, and subsequent CT scan was negative.
 
Within a few weeks of the car accident, the patient became extremely depressed and anxious. He quit school because he could no longer do the work, his relationships fell apart, and he had severe insomnia. He had a significant suicide attempt 1 year after the car accident, and was in the ICU for several days.
 
Past medical history was significant for history of asthma, abdominal distress with bloating and pain in the region under the ribs. He smoked (both tobacco and marijuana which he said calmed him). He had severe daily pounding headaches. His left ear heard sounds, but words and concepts became jumbled when he attempted to listen on the telephone with his left ear. He could hear perfectly well with the right ear.
 
Physical examination: well developed, well nourished male, appearing extremely depressed, with flat affect and slow movement. Physical examination was essentially normal, with the following exceptions:
* Multiple tender points on the scalp.
* Marked clamminess and coolness of hands and feet.
* Pulses: deep and slow, diminished in all 3 positions on the left, with marked left/right imbalance.
* Tongue: Moist, somewhat pale, multiple cracks in the midline, worse in rear position, damp slightly yellowish coating in middle and rear positions.

 
Neuro-developmental and neuro-processing assessments (motor, tactile, auditory and visual processing) showed marked impairment of auditory discrimination (worse in the left ear), marked disturbance of tactile discrimination, with relatively normal motor processing.
 
Food allergy testing (using an immuno-assay known as the ALCAT test) showed multiple foods to which the patient reacted strongly, and which were subsequently eliminated from his diet.
 
qEEG (Quantitative EEG) was analyzed to diagnose brain processing issues. This specialized EEG,  also referred to as a Brain Map, analyzes brain wave activity as measured using an electrode cap and the standardized international 10/20 system of lead placement. The patient’s brain wave activity (qEEG) is compared to other individuals of the same age using analyzing software developed by the National Institute of Health (NIH).  The analysis software received FDA approval as an objective measure diagnosis tool for conditions including LD, ADHD, Bi/Unipolar depression, and many others.
 
This particular patient showed significantly increased power in the theta (associated with emotionality), alpha (associated with state of relaxed awareness) and beta (associated with focusing on task) band widths (despite his appearance of depression), with marked power asymmetry (i.e. left-right imbalance) worse in the temporal and central motor planning areas, and marked increase in coherence in the alpha, theta and delta bandwidths, resulting in inflexibility, “squirrel cage phenomenon”, the inability to get out of a rut. There was clear loss of cortical function, consistent with post concussion syndrome. There was incomplete communication between brainstem through the midbrain to the cortex, resulting in marked brain processing disorganization, which can lead to severe anxiety and paralysis. 
 
Treatment was aimed at redeveloping and integrating the peripheral nervous system, retraining the central nervous system (breaking up neuro-inhibitors, exercising and training the brain to a more normal brain wave pattern), stimulating the organs in charge of brain activity, and balancing the energy of the entire system.
 
Methods:
* neurotherapy – using the FLEYX system[12] of visual neurotherapy, and the Brain Master[13] training.
* Dynamic Listening System – which uses especially engineered music, mostly classical, to retrain the ear to those frequencies which it was suppressing, opening up the cortex via auditory stimuli, and reducing the hyperacoustic state which overwhelms and irritates the cortex, contributing heavily to anxiety and depression.
* Acupuncture – to stimulate the Kidney, stimulate growth of neural pathways, move Liver Qi
* Meridians used were mainly Shao Yin Tai Yang, with multiple focus points in the scalp, on the gallbladder meridian, depending on the patient’s sensitivity, and the areas which the brain map demonstrated to be out of balance. These points were mainly GB-8, GB-18, and sensitive points surrounding the ears.
* Kidney cerebral circulation (anterior and posterior) to stimulate both the ears and the brain
* Auricular acupuncture, to stimulate specific areas of the brain via the gateway of the ear.

* Herbal therapy, again to stimulate the Kidney, and growth of neural pathways.
* Strengthen the Root (East West Herbs) in the morning for Yang energy
* Nourish the Root (East West Herbs) in the evening for Yin and Kidney Essence.

Impression, diagnosis

Western diagnosis: Post concussion syndrome                   Depression                                           Impairment of auditory discrimination      Disturbance of tactile discrimination        Food allergy

Code 310.2 296.2 388.43 782.0 693.1

Chinese medicine diagnosis: Shao Yang Wood biopsychotype Liver Qi stagnation with Liver Fire Blazing Spleen Qi deficiency Food stagnation

 


Treatment:

• Neurotherapy using the FLYXX neurofeedback system, to regularize the overall electro-encephalogram patterns which were is disarray.
• Auditory processing training, to stimulate and regrow disturbed auditory pathways, leading to marked improvement in functioning of the brain as a whole.
• Acupuncture (scalp and body), concentrating on the Shao Yin Tai Yang meridian, to support and stimulate poorly functioning neural pathways, moving into the Chong Mo and Dai Mo, with focus points on the scalp using multiple gall bladder meridian points, moved to Tai Yin Yang Ming meridian to support and stimulate logical thinking
• Food allergy testing (using the ALCAT immunoassay), diet based on results of the test.
• Mentoring as issues came up to put life experiences into proper perspective. 
  

Results:
Within the first 10 days, with acupuncture twice a week and neuro-therapy with auditory processing rehabilitation four times a week, the patient experienced a clearing of his thoughts, and a sense of being alive for the first time in several years. During the course of therapy, about 12 weeks duration, the patient stopped drinking alcohol, stopped smoking tobacco and marijuana, and eliminated from his diet those foods to which he had a reaction by they ALCAT test.
 
After 10 weeks of therapy, the brain map had cleared almost completely, the patient no longer had any symptoms of depression at all, his brain processing had returned to normal, and he was discharged from the CrossRoads program. His abdominal distress was no longer present, he no longer had any headaches, and he could hear (and comprehend) with no difficult using his left ear. He was accepted in college, where he is currently completing requirements for his bachelor’s degree.
 
He continues to do well, as long as he avoids foods to which he is sensitive. He will take the herbal formulae to strengthen the brain for about 18 months. By that time, his system should have stabilized enough that he will be able to live a normal life, without medication. He told us that he felt his life had been given back to him.