Can new technology help with movement disorder?

Ask Dr. Keith Roach M.D

DEAR DR. ROACH: Every day we hear of concussion protocols in rugby, soccer and American football. However, in boxing, the aim is to knock your opponent unconscious — that is, induce a concussion. Concussions! What the heck? — Anon. ANSWER: A concussion is an acute traumatic brain injury, usually due to contact. You do not need to be knocked unconscious to have had a concussion. Most concussions occur without loss of consciousness. Further, loss of consciousness does not necessarily predict a worse concussion. The severity of concussion is assessed 30 minutes after the injury through a clinical scale called the Glasgow Coma Scale. Confusion and amnesia are the most common symptoms of concussion, but others, including headache, dizziness, nausea and vomiting can occur, sometimes hours after the event. Following concussion, many people have changes in their mood and ability to concentrate, difficulty communicating, and poor motor coordination. Recovery can occur in less than a week, or it can be delayed three weeks or longer. I have had patients with post-concussive symptoms months after the concussion. Concussions are common in amateur boxing. One study found that concussions occur 13% of the time a boxer steps into the ring for a competition. With repeated head injury comes a risk of chronic traumatic encephalopathy, which you have probably read about in professional American football players. It is not known exactly what proportion of boxers will develop CTE; however, the condition has been known for nearly a century as “dementia pugilistica.” A study from 50 years ago estimated that 20% of retired professional boxers had signs of chronic traumatic brain injury, but far fewer amateur boxers are thought to. Medical professionals have debated banning boxing entirely (one referred to it as a “state-condoned assault” and “a relic of the barbarity of earlier eras”), while others have recommended ways of making boxing safer, including, as you say, concussion protocols, in order to let the brain recover. *** Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYour-GoodHealth@med.cornell. edu or send mail to 628 Virginia Dr., Orlando, FL 32803.