Etiological factors may vary from a minor blow to the head, often combined with a whiplash-type injury of the cervical spine resulting in a symptom complex that may be minimal in degree. However, when the trauma is more severe, it may render the patient comatose for prolonged periods of time and even result in death. In most instances, symptoms are brief in duration and last for a matter of days to several months.

The Center for Disease Control and Prevention defines concussion as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces, secondary to direct or indirect forces applied to the cranium.”

Symptoms can last from minutes to days and in some instances become chronic or permanent. Early symptoms include headaches, pain in the cervical spine, nausea, dizziness, an inability to focus or concentrate, memory loss, visual disturbances and in a small number of cases induce loss of consciousness or even coma.

The Glasgow Coma Scale classifies concussion based upon the level of consciousness of the patient. Mild concussion typically allows complete neurological recovery. Moderate concussion can result in stupor and lethargy. In cases of severe concussion, patients may experience a comatose state, a heightened risk of hypotension, hypoxemia and edema of the brain. Invariably, all forms of concussion result in varying degrees of inflammation of neurological tissue, accompanied by pain and neurological impairment.

It has been determined that MRI, PET scans, EEG studies, etc., generally do not reveal any significant abnormalities in the early phases of the disease. Macroscopic changes of cellular tissues may not accompany the symptoms that exist until a significant period of time has elapsed.

Usually, traumatic episodes that result in concussion include a collision with an opposing player when engaged in sports activities, falls and other incidents sustained in the home, motor vehicle accidents and the numerous traumatic episodes related to military activities. The majority of episodes cause only minor symptoms, which usually disappear over a finite period of time, in most cases without any specific therapy being applied.

It has been calculated that somewhere in the vicinity of 10 to 20% of all cerebral concussions that have been formally diagnosed result in symptoms, which if they persist over a period of time may become chronic. In all of these cases, appropriate therapy should be applied and continued until the patient has been asymptomatic for a period of at least 2 months while engaged in relatively normal activities.

The symptoms most frequently reported consist of headaches which may take many forms. Generally, they are fronto-occipital in location accompanied by pressure sensations, stabbing, aching, throbbing, etc. They may be intermittent or exist on a 24/7 basis. The majority of these patients also complain of pain in the cervical spine with or without radiation to the upper extremities. Insomnia, irregular sleep patterns and cognitive impediments may be minimal to extreme. These include difficulty in finding words, the normal comprehension of reading material, TV content, an inability to focus and concentrate and in essence, mentation is impaired in varying degrees. Memory loss may be short or long term and in some instances both. Often this relates to the duration of the period of loss of consciousness, which however in the majority of cases does not occur. As previously indicated, the injury may induce a prolonged state of coma or even death.

Symptoms may also include a loss of sense of taste, reduced auditory acuity, tinnitus and visual disturbances including blurring, double vision, etc. Both light and sound sensitivity are frequent and may persist. The patient may be unable to attend school, work, lose the ability to socialize and be unable to engage in normal relationships. Irritability with periods of labile mood disorders may be accompanied by loss of anger control. Fatigue, anxiety and depression may be present in both the early and late phase of cerebral concussion. With the development of chronicity however, they may become the most dominant long-term problems.

An increasing number of neuroscientists believe that many years later, neurological diseases such as Parkinson’s disease and the dementias may result from a traumatic episode of the brain experienced much earlier in life and long forgotten.

All patients who have sustained cerebral concussion with persistent symptoms should be monitored until asymptomatic and in most cases based on clinical findings and progress, should be subjected to curative Laser Therapy and in some instances preventative treatment.

Certainly, in patients who remain symptomatic even for a week without improvement, a course of Laser Therapy based on thorough clinical evaluation is advisable. A standardized or individual customized course of treatment for each patient should be administered as clinically indicated.

In conclusion, all patients who have sustained a cerebral concussion should undergo an ongoing course of Laser Therapy, unless symptoms improve rapidly post-trauma spontaneously. The purpose for this is not only to relieve symptoms but to prevent chronic damage to the intracranial tissues. Therapy can be standardized or customized and ideally should be applied every 2 days initially.
• Depending on clinical change, the protocols are changed according to the progression or resolution of the severity of the symptoms.
• This applies particularly for patients who are severely affected and present for an assessment relatively early after the injury.
• In chronic cases where symptoms persist regardless of the time period elapsed since the trauma, curative therapy should continue for at least 2 months subsequent to the resolution of all symptoms. Depending on the nature and duration of the injury and unless symptoms are improving rapidly spontaneously, treatment should be applied as early as possible and continued for a minimum of 8 weeks during which the patient is able to engage in normal activities.
• Each case must be assessed on its own merits and treated accordingly.
• In our experience, Laser Therapy should be considered the treatment of choice and be continued until the patient is asymptomatic, fully active and does not require any other therapy, including medications.

Conclusion: All patients who have sustained a cerebral concussion and continue to demonstrate symptoms receive a course of Laser Therapy tailored to their individual situation. Ideally therapy should be continued every second day until the patient has become asymptomatic for at least 2 months.

Generally, protocol settings are initiated at lower levels and increased in accordance with clinical change. As symptoms diminish in the degree of severity, the frequency of treatment can be gradually reduced, but not during the first 2 to 4 weeks.

All patients require periodic clinical assessment incorporating appropriate measurements to determine improvement as the course of treatment progresses. Symptoms should diminish rapidly in most instances when all appropriate parameters are observed.

The entire process should result in a significant improvement/cure rate in all categories of cases treated. This should be accompanied by the restoration of the patient’s quality of life, normal activity levels, and a total absence of symptoms.

Purpose of Article – to Demonstrate the Efficacy of Laser Therapy in the Treatment of Neurological Problems.

The case presented is that of a 62-year-old Firefighter. The patient began to experience unilateral sensorineural hearing loss in the left ear, along with vertigo and severe headaches in April, 2016. An MRI of the brain was performed a week later and revealed that a grade 2 ependymoma was present in the 4th ventricle. This was impinging on the dorsal medulla.

The patient was subjected to a craniotomy in order to remove the tumour on June 7, 2016, followed by a course of radiation therapy.

During his recovery, he developed paralysis of the left lateral rectus muscle leading to diplopia. In addition, he was experiencing a lack of balance, nystagmus, severe headaches, slurred speech, difficulty swallowing and fatigue.
Prism glasses were prescribed to alleviate the visual problem, but no improvement was noted. He was told to wait 18 months in the hope that the diplopia, etc. would improve. 15 months post-surgery, his symptoms persisted and some additional symptoms had developed. These included sleep disturbances, memory loss, irritability, depression, anxiety, loss of taste and tinnitus. He presented at the Meditech Rehabilitation Clinic on January 9, 2018.

Physical Examination:

The patient was noted to be right-handed. The right grip was 105 lbs. and the left was 100 lbs.
Range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion was 50% of normal.
There was a loss of the normal curvature of the cervical spine and moderate tenderness, C1-C6.

There was limited abduction of the left lateral rectus muscle with bilateral nystagmus on gazing to the left.

Initial Diagnosis: Post-Surgical Resection of Malignant Ependymoma
4th Ventricle with Multiple Neurological Sequelae.

TREATMENT AND PROGRESS:

The patient initiated treatment using Laser Therapy at the Meditech clinic on January 9, 2018. Initially, treatment was confined to the occiput, cervical and upper thoracic spine. Irradiation of the brainstem and cerebellum were included with the cervical treatments. Following 5 treatments of these areas over 5 days, treatments were extended to the cerebral hemispheres, initially targeting the occipital lobe. Over several additional days, treatment of the cranial hemispheres was extended to include the temporo-parietal and the frontal lobes. These targeted the motor, sensory and speech centres of the brain.

After 3 sessions of daily treatment at our clinic, including the cerebral hemispheres, the patient noted that his horizontal gaze was more balanced, and the diplopia from which he suffered was disappearing. After an additional week, there was marked improvement in the lateral abduction of his left eye and the double vision had disappeared. His energy levels were elevated and he was able to be more active physically. At this point, his caregiver had been trained to utilize the equipment preset for treatment at home and this is continuing.

RELEVANT DATA:

Ependymomas are a type of tumour of the glial cells (supporting cells of the brain) that starts in the ependyma. The ependyma lines the fluid-filled spaces in the ventricles (cavities) of the brain and the centre of the spinal cord. Ependymomas spread to the cerebrospinal fluid more often than other gliomas. They do not spread outside the brain or spinal cord. Based on the World Health Organization (WHO) grading system, ependymomas are classified as low to high grade (grades 1–3). Low-grade tumours (grade 1) are more common in the spine while grade 2 tumours are more common in the brain.

Symptoms depend on the tumor location. The most frequent symptoms include:
• Headache and intracranial pressure
• Nausea and/or vomiting
• Blurred vision
• Weakness or numbness and tingling
The cause is not known. It rarely occurs in multiple family members, although does occur in people with Neurofibromatosis type 21.

Treatment is usually based on the size of the tumour and the symptoms that occur. Surgery may be performed to remove all of the tumour or as much of the mass as possible. Low-grade tumours may not need further treatment if the entire tumour can be removed. Radiation therapy may be given after surgery for grade 1 and 2 tumours if the tumours can’t be completely removed. Radiation therapy is given after surgery for anaplastic tumours. It may also be used to treat tumours that return after treatment (called recurrent ependymomas) if radiation therapy was not given previously. It may be given to the entire brain and spinal cord if tests show that the cancer has spread through the cerebrospinal fluid2.

Brain surgery and the consequent radiation therapy following the procedure is a major medical event which carries numerous associated risks including an allergic reaction to anesthesia, intracranial bleeding, blood clots, edema, coma, impaired speech, vision, coordination, or balance, infection in the brain or at the wound site, memory problems, seizures and strokes. Aside from some of the side effects mentioned, our patient also sustained nerve damage of the abducens nerve (6th cranial nerve)3.

The sixth nerve leaves the brainstem at the pontomedullary junction and follows an upward and outward path. The long intracranial course of the abducens nerve makes it vulnerable to injuries, most often at the site of the dural entry point and at the petrous apex. Although traumatic palsy of the sixth nerve is usually seen in combination with intracranial hemorrhage, skull fracture, facial fracture or elevated intracranial pressure, it may occur in the absence of such lesions.

The appropriate management of posttraumatic or post-surgical isolated abducens nerve palsy remains a matter of debate. Spontaneous recovery from sixth nerve palsy usually occurs within 6 months, with improvement noted in most cases at 3 months4. Our patient remained symptomatic 15 months post-surgery.

Laser therapy has a favourable prognosis in the regeneration of peripheral nerves in both neurosensory and neuromotor deficits, such as trigeminal neuralgia, neuropathy, low back pain with sciatica, and herpes zoster. Application of laser produces both local and systemic effects that can stimulate the nerve regeneration process. Moreover, laser therapy improves the recovery of the injured peripheral nerve and decreases post-traumatic retrograde degeneration of the neurons in the corresponding segments of the spinal cord. Research studies have shown that Laser therapy increases the functional activity of the injured peripheral nerve, prevents or decreases degeneration in corresponding motor neurons of the spinal cord, and improves axonal growth and myelinisation.

Bernal previously found that Laser Therapy is an excellent complementary medium for the recovery of facial nerve paralysis and provides a painless therapeutic alternative without side effects that can be used on any type of patient, including those who cannot use corticosteroids, such as diabetics and hypertensive patients. In addition, Ladalardo et al. studied the effect of GaAs diode laser in patients with Bell’s palsy and used THE House-Brackman Facial Nerve Grading System (HBS) to assess the outcome. In that study, patients who received the treatment showed a functional improvement ranging between one and three grades on the HBS. One of the possible explanations of the laser effect is through an increase in the activity of enzymes involved in the mitochondrial respiratory chain, such as cytochrome C oxidase and adenosine triphosphatase (ATP), thereby leading to an increase in ATP production in mitochondria. In addition, it increases DNA synthesis as well as collagen and pro-collagen production. The anti-inflammatory effect of laser therapy can be caused by a reduction in the levels of pro-inflammatory cytokines, such as interleukin-1 alpha (IL-1α) and IL-1 beta (IL-1β) as well as an increase in the levels of anti-inflammatory growth factors and cytokines, such as basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), and transforming growth factor-beta (TGF-β). In addition, laser irradiation causes dilatation of blood vessels, which also leads to a reduction in swelling caused by inflammation. It may also have inhibitory effects on the release of prostaglandins, cytokine levels, and cyclooxygenase (Cox) 2, and has been shown to accelerate cell proliferation, collagen synthesis, and tissue repair. Laser Therapy may also have a direct effect on nerve structures, which could increase the speed of recovery of the conduction block or inhibit Aδ and C fiber transmission. Moreover, it was reported that
Laser Therapy significantly widens the arterial and capillary vessels, increases
microcirculation, activates angiogenesis and reduces edema caused by inflammation. It also stimulates the immunological process and nerve regeneration5.

Our experience in the treatment of this patient firmly establishes the positive effects of Laser Therapy. Based on current therapeutic methods, this approach is superior to those being utilized and can therefore be termed the treatment of choice in the resolution of symptoms associated with these neurological conditions. Moreover, application is safe and does not have any of the potential adverse effects of steroids, botulinum toxin injections and unquestionably accelerates the resolution of post-surgical sequelae.

References:

1. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/ependymoma/?region=on

2. http://www.cern-foundation.org/education/ependymoma-basics

3. https://www.healthline.com/health/brain-surgery#followup

4. Asproudis I, Vourda E, Zafeiropoulos P, Katsanos A, and Tzoufi M. Isolated abducens nerve palsy after closed head injury in a child. Oman J Ophthalmol. 2015 Sep-Dec; 8(3): 179–180.

5. Salaheldien M, Alayat M, Elsodany AM, Abdel Raouf El Fiky A. Efficacy of high and low level laser therapy in the treatment of Bell’s palsy: A randomized double blind placebo controlled trial. Lasers Med Sci (2014) 29:335–342

Edit: February 6, 2018

CLINICAL ABSTRACT

Purpose of Article: To demonstrate the efficacy of Laser Therapy in the Treatment of Chronic Cerebral Concussion.

The patient is a 38-year-old individual who presented complaining of multiple cognitive impediments. On careful questioning, he recalled sustaining a severe concussion at age 5, after falling six feet from a fence. Evidently he lost consciousness for an undetermined period of time and was taken to the hospital by his parents. A number of investigative procedures were performed, however no therapy was provided.

From that time on, the patient had a difficult upbringing, experiencing problems with all relationships including his parents, at school working with teachers and subsequent to completing his education, maintaining a job. He had been on Zoloft for depression for many years. He stated that he had been diagnosed with “Obsessive Compulsive Disorder”, has difficulty organizing, is subject to chronic “brain fog” and has severe pain in the cervical spine. These problems had become well established and the patient summarized his status as being unable to get along with anyone, achieve any level of success in his work objectives and generally preferred to live alone as an introverted, problematic recluse.

PHYSICAL EXAMINATION:
On initial examination on August 18, 2015, the patient was noted to be right-handed. The right grip was 90 lbs and the left was 80 lb. Range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion was 60% of normal. A loss of the normal curvature of the cervical spine was noted, along with significant para-cervical muscle spasm and moderate tenderness from the occiput to T1.

The patient’s attitude was extremely negative and with regard to movements and speech, he appeared to be hypoactive. The neurological examination was grossly within normal limits however a bony depression was noted over the left frontal bone, attesting to the initial injury at age 5 years. Generally speaking, the patient was minimally communicative and appeared to be locked in a protective shell.

The initial diagnosis formulated after a prolonged period of questioning, and the physical examination, was–Cerebral Concussion (chronic, severe).

The case clearly represented the clinical picture of a chronic case of Cerebral Concussion and it was somewhat doubtful after the period of time that had elapsed from his initial injury that improvement in his condition could be provided.

COURSE OF TREATMENT: Treatment was initiated using the BioFlex Laser Therapy System on August 22, 2015. Initially, treatment was confined to the cervical spine, including the occiput and upper thoracic spine. Irradiation of the brainstem and cerebellum were included in this process. Following five treatments of this area on consecutive days, treatments were extended to the cerebral hemispheres. Initially only the occipital lobes were targeted but as the course of treatment advanced, treatments were extended to the temporo-parietal and frontal lobes. These focused on the motor, sensory and speech centres of the brain.

After the initial three days of treatment, the patient reported that he was experiencing petit mal seizures at night. He also revealed that the house he grew up in had high lead levels which he was exposed to during his formative years. At this point in the course of treatment, he noted that the chronic “brain fog” was gradually being replaced by clarity and his reading abilities had begun to improve.

At this time, he began to reduce the intake of Zoloft, which had been prescribed for his chronic depression.

As therapy progressed, range of motion of the cervical spine improved to a relatively normal level. After 12 treatments of the cervical spine over a course of three weeks, along with applications to the cerebral hemispheres, he reported that he was able to engage in more physical activities and his mental clarity continued to improve. In addition, he commented that his emotional status was more stable, his energy levels had increased and the periodic petit mal seizures had almost completely disappeared. After six weeks of treatment, the patient felt that he had improved sufficiently on the functional level that he decided to discontinue treatments.

Two years following the completion of treatment, the patient presented with another problem and at that time, we did not recognize him. There was a complete change in his appearance, demeanor and his communicative skills. On questioning, the patient revealed that his lifestyle had improved substantially, although he was still using Zoloft periodically. Conversational levels were relatively normal, the patient was optimistic and there was no evidence of any psychological or behavioural problems.

He indicated that he had been holding a steady job for the past year, had moved to a higher level environment, appeared to be well groomed and communicated with a great deal of self-assurance. Indeed, when I saw him in the waiting room, I had difficulty recognizing him. For the first time since I had known him, he was optimistic with regard to the future and felt that his life was continuing to improve on all levels.

RELEVANT COMMENTS: In the past, there has been minimal progress in developing effective treatments for chronic brain injuries, particularly in cases of multiple cerebral Concussions. This patient illustrated the tremendous benefit that can be induced by appropriate Laser Therapy. The changes in this patient were dramatic from all perspectives, particularly his speech and energy levels. The patient stated that the quality of his life had normalized and looked forward to the future with optimism.

Arthritis

There are many forms of arthritis, the most common being degenerative osteoarthritis.

Some facts excerpted from The World Health Organization literature indicate several shocking realities.*

• Arthritis is considered to be the nation’s number one crippling disease and the most common chronic disease of people over the age of 40.
• According to the Center for Disease Control and Prevention, an estimated 46 million adults in the United States have been told by a physician that they have some form of arthritis, including degenerative osteoarthritis, rheumatoid arthritis, gout, lupus or psoriatic arthritis.
• By 2030, a startling 67 million Americans age 18 years or older are projected to have arthritis—a 45% increase from current statistics.
• The average age that arthritis begins is 47 years, with 1 in 2 Americans over age 65 dealing with some form of arthritis.
• The cost of arthritis due to lost wages, medical treatment and other related expenses can run an individual over $150,000 in expenses over their lifetime.

These facts are significant–the solutions less so. Physicians are prone to prescribing analgesics, anti-inflammatory medications and muscle relaxants or inject cortisone, xylocaine and a variety of lubricating solutions. All of these mask symptoms temporarily, however they do not provide a permanent solution.

Laser Therapy, a relatively new technology perfected by Meditech International Inc. in Toronto, Canada currently offers up-to-date, professional therapeutic systems along with Home Units for utilization by individuals who have not had their problems resolved by conventional and traditional methods, including surgical procedures. Symptoms generally improve immediately following the institution of Laser Therapy. Applying treatment in a cumulative fashion stimulates the reduction of symptoms over time resulting in the patient’s return to a normal range of activities without the utilization of analgesics or other medications.

Unfortunately Laser Therapy is seldom mentioned as a solution as it is not covered by the codes, insurance programs, national health care systems and other mainstream regulatory bodies. The reasons: medicine is slow to change and vested interests will go to great lengths to provide protection for their products, regardless of the lack of value induced.
At this point in time, it must be clearly understood that the BioFlex Laser Therapy Systems offer ongoing relief of symptoms of arthritis in all areas of the body by restoring the normal morphology and function of the cells.

In addition, the therapy provides a potent anti-inflammatory effect and boosts the immune system while restoring the integrity of the cells. Regeneration of cartilage is also a part of this process, which is administered in a pain-free and completely safe manner.

Comparatively speaking, the cost is minimal and each treatment stimulates the healing process to a higher level, making surgical interventions such as arthroscopy, joint replacements and spinal surgeries in the majority of instances redundant.

As time progresses the patient can discard all pharmaceuticals and focus on a healthy diet and activities such as swimming, stretching and walking to achieve a complete recovery.
The facts regarding the efficacy of Laser Therapy are undeniable. At our Meditech Rehabilitation Clinics, this reality can be seen many times over the course of each day and the changes which patients often describe as “a miracle” have come to be an almost standard outcome.

A recent example of results achievable is the case of Jerome Williams, also known as “J.Y.D.” or Junk Yard Dog, a brand label that he has acquired over a stellar ten year career in the NBA.
Jerome presented for treatment at one of our clinics in April and immediately noted improvement. He acquired a Home System and a month later, a Professional System for stationary therapy at his home in Las Vegas, Nevada. The results achieved have been so dramatic that at the age of 44, he has returned to a professional career in basketball in the newly formed 3D League.

Once again, his play is outstanding and in addition he is continuing his long-standing career with the NBA as a goodwill ambassador of the league. J.Y.D. is also involved in many charitable and educational organizations in his post-NBA career. I am pleased to state that he is a perfect example of what can be accomplished with the intelligent application of BioFlex Laser Therapy, a technology that can replace all current and conventional treatments for arthritis.

For additional information, contact Meditech International Inc., Toronto, Canada 416-251-1055, or review our website www.bioflexlaser.com.

ABSTRACT

This patient demonstrates the benefits of Laser Therapy in the treatment of the neurological problems that typically present at our clinic. It cannot always be accurately determined how much benefit is obtained secondary to Laser Therapy, but in this case, prior to February 2017, the patient’s status had plateaued completely. Subsequent to the initiation of Laser Therapy in February 2017, his ability to speak and the improvement in his visual fields, in view of the absence of other factors, must therefore be attributed to Laser Therapy.

CASE PROFILE:

• Chiari Malformation-Left Temporal Lobe with spontaneous intracranial bleeding episode. (December 31, 2015)
• Emergency Craniotomy. (January 1, 2016)

MEDICAL HISTORY:

The patient is a 22-year-old male, who had been diagnosed with an intracranial arteriovenous malformation in the left temporo-parietal area, diagnosed two years prior to treatment at our facility.

At that time, he had sustained an intracranial hemorrhage with a subsequent rise in intracranial pressure. The situation required an emergency craniotomy in order to evacuate the hematoma in the left posterior temporo-parietal lobe.

An MRI post-surgery revealed a discrete area of encephalomalacia involving the parietal operculum and the posterior temporal lobe extending to the left side of the brain.
As a result of the surgery, the patient continued to have significant visual disturbances, memory loss, cognitive issues and aphasia. His ability to speak was markedly reduced, along with comprehension at many levels. An automated visual field perimetry study performed post-craniotomy revealed a total inferior right homonymous quadrantanopsia, consistent with the cortical damage that had occurred.

PHYSICAL EXAMINATION (February 2017):

Aside from the visual impairment and aphasia, there was a modicum of findings with regard to other abnormalities.
There was a loss of normal curvature of the cervical spine and moderate tenderness over this area.

DIAGNOSIS:

• Chiari Malformation-Left Temporal Lobe with spontaneous intracranial bleeding episode.
• Emergency Craniotomy.
• Visual Field Impairment/Aphasia, along with Moderate Cognitive Impediments

DISCUSSION:

The patient received a total of four Laser Therapy sessions involving the cervical spine, brainstem and cerebellum at the Meditech Rehabilitation Clinic beginning February 21, 2017. As he lived at a distance from the clinic, his caregivers were trained on the utilization of the Home System and continued the treatment subsequently at regular intervals. The areas treated included the cerebral hemispheres and the cervical spine.

After several weeks of treatment, the patient’s attendance at university was resumed.

Six months post-initiation of Laser Therapy, the patient had a follow-up appointment with his ophthalmologist. An automated visual field perimetry study was performed and revealed a 10% decrease in scotoma. The quadrantanopsia did not cross the vertical midline.

Enclosed in this communication are his visual fields prior to starting Laser Therapy and six months after continuing treatment. His ophthalmologist was impressed with the improvement noted considering that the trauma had occurred almost two years prior to initiating Laser Therapy. His initial quadrantanopsia had been considered to be permanent.

As his improvement in speech and vision are continuing to move forward, the patient was advised to continue with both the cranial and cervical Laser Therapy under our supervision.

INTRODUCTION:

For over 30 years, Laser Therapy has been effectively used in the treatment of many medical conditions, including musculoskeletal, dermatological problems, wound healing and more recently, the treatment of neurological conditions.

The technology has been utilized for over 40 years and over the past two decades, has made significant progress. Laser Therapy is a non-invasive, light-based therapy that applies a combination of red and infrared light sourced from red and infrared LED’s and laser diodes.

Photon particles are absorbed by the mitochondria through cytochrome c oxidase, causing a photodissociation of nitric oxide from cytochrome c oxidase resulting in increased cellular ATP levels. The dissociated nitric oxide levels also promote vasodilation and improve arterial perfusion.

Transcranial Laser Therapy has been demonstrated to significantly improve outcomes in patients of all types. Lampl et al wrote that “Although the mechanism of action of infrared laser therapy for stroke may not be completely understood, infrared laser therapy is a physical process that can produce biochemical changes at the tissue level. The putative mechanism involves stimulation of ATP formation by mitochondria and may also involve prevention of apoptosis in the ischemic penumbra and enhancement of neurorecovery mechanisms.”¹

Apart from ischemic heart disease, stroke (CVA) is the leading cause of death worldwide. The current approved treatment is to apply tissue plasminogen activator within 3 hours of onset of a CVA. Although this method is effective in clearing blood clots, the narrow time window that exists for effective treatment limits treatment options for the majority of stroke victims.
Laser Therapy has been investigated as an alternative treatment for CVA and has been shown to have a neuromodulatory and neuroprotective effect, while regulating many biological processes.

MECHANISMS OF ACTION

Photon particles are absorbed by the cerebrospinal fluid and distributed throughout the cranium, including the ventricles. These confer a significant neuromodulation effect. The particles of energy are also absorbed by the arterial, venous and lymphatic systems and are thereby transported to the fluid surrounding the central nervous system and the spinal cord. Additional benefit is transmitted by direct irradiation of the soft tissues and the skeletal system of the area involved.

1Lampl Y. Zivin J.A. Fisher M. Lew R. Welin L. Dahlof B. Borenstein P. Andersson B. Perez J. Caparo C. Ilic S. Oron U. Infrared laser therapy for ischemic stroke: a new treatment strategy: results of the NeuroThera Effectiveness and Safety Trial-1 (NEST-1) Stroke. 2007; 38:1843–1849

Automated Goldmann Visual Fields (December 23, 2016)

• Right Homonymous Inferior Quadrantanopsia
• This is a typical “pie on the floor” appearance in a visual field that conveys involvement of the optic radiation as it traverses the left temporo-parietal lobe. Note complete scotoma of the left lower quarter visual field.

Automated Goldmann Visual Fields (August 18, 2018)

• Right inferior quadrantanopsia
• Scotoma is not homonymous in this visual field. Note 10% improvement in both visual fields with sparing of the central visual field