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Review of the Management of Pediatric Post-Concussion Syndrome—a Multi-Disciplinary, Individualized Approach

Current Reviews in Musculoskeletal Medicine volume 12, pages 57–66 (2019)Cite this article

Abstract

Purpose of Review

Post-concussion syndrome (PCS), when the patient’s concussion symptoms last longer than 4–6 weeks, affects 10–30% of concussion patients. PCS presents a significant source of morbidity to patients and a management challenge to providers. In this review, we present the current evidence and best management approaches for pediatric PCS.

Recent Findings

There is limited high-quality evidence in pediatric PCS. There is some evidence supporting pharmaceutical management of post-traumatic headaches, cognitive symptoms, and emotional symptoms. Vestibular-ocular dysfunction should be evaluated and managed appropriately. Neuropsychological recovery is expected, but requires appropriate attention to Return to Learn. Emotional symptoms are common in PCS and the evidence supports treatment with cognitive behavioral therapy.

Summary

PCS presents a unique therapeutic challenge affecting multiple domains for patients—physical, sleep, cognitive, and emotional. Successful management of PCS requires a multi-disciplinary and individualized approach. There remains a significant need for further research, specifically looking into the outcomes and effective interventions in pediatric PCS.

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Affiliations

  1. Division of Pediatric Rehabilitation Medicine, Mission Hall, UCSF Benioff Children’s Hospital, Box 0110, 550 16th Street, 4th Floor, San Francisco, CA, 34143, USA

    Mitul Kapadia

  2. University of California, San Francisco, CA, USA

    Mitul Kapadia

  3. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA

    Alison Scheid

  4. Department of Neurology, University of California, San Francisco, CA, USA

    Eric Fine

  5. Berkeley, CA, USA

    Rachel Zoffness

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  1. Mitul Kapadia
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  2. Alison Scheid
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Correspondence to Mitul Kapadia.

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Mitul Kapadia, Alison Scheid, Eric Fine, and Rachel Zoffness each declare no potential conflicts of interest.

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Kapadia, M., Scheid, A., Fine, E. et al. Review of the Management of Pediatric Post-Concussion Syndrome—a Multi-Disciplinary, Individualized Approach. Curr Rev Musculoskelet Med 12, 57–66 (2019). https://doi.org/10.1007/s12178-019-09533-x

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  • DOI: https://doi.org/10.1007/s12178-019-09533-x

Keywords

  • Post-concussion syndrome
  • Mild traumatic brain injury
  • Pediatric concussion
  • Post-traumatic headache
  • Cognitive behavioral therapy