Michael Collins, a leading American concussion specialist, identifies six different types of concussion. Each of these is characterised by different types of symptoms and should be treated in a distinct way. They are not mutually exclusive, so you might have more than one of these, or even the full house:
- cognitive fatigue (including concentration problems, brain fog, distractability)
- vestibular (problems with balance, co-ordinating head and eye movements, motion sensitivity)
- ocular (problems with eyes working together rather than poor vision per se, so ocular-motor really)
- migraine (headache with nausea, light or noise sensitivity)
- anxiety (excessive worry, rumination, low mood)
- neck (due to damage to neck or spinal cord, less common)
Six types of concussion and how to treat them (short article)
Six types of concussion – Infographic pdf
Michael Collins – short video summary (3 and a half minutes)
Michael Collins – detailed interview (over one hour) – “there are highly effective treatments for this injury”
The long interview gives more information about the treatment approaches for the different types. For example, vestibular concussions require activities to challenge the vestibular pathways in the brain, while having high anxiety (caused by excessive sympathetic nervous system arousal – being too much in ‘fight or flight’ mode) can be helped by physical exercises to stimulate the parasympathetic nervous system, to relax you.
He also notes that problems with one system, such as the vestibular system, can have numerous knock-on effects on other systems, which is why specialist diagnosis is important to figure out the root problem(s) and treat them effectively.
It all sounds very promising. However, I don’t know how or if you can get assessed for this in the UK.
I haven’t been assessed but I mainly have cognitive problems so presumably have a ‘cognitive’ concussion, which is apparently one of the least common. I initially also had vestibular problems which improved a lot after rehabilitation – I was told these were due to inner ear damage but I’m now wondering if there’s also a central brain element to these, and if I have a ‘vestibular concussion’ too.
If I find out more about how to get assessed or the different treatment approaches for the different types, I’ll add it here.