Concussion Center assesses Belleville patients whose symptoms after a head injury were put down to stress or anxiety. Vestibular and oculomotor testing finds the physical injury that anxiety treatment misses. The first appointment takes about an hour. It ends with a plan aimed at the affected systems.
Belleville is the largest city in the Metro East. It is also the longest drive we ask of an Illinois patient. The drive is worth it when symptoms after a head injury have been blamed entirely on stress or on mood.
Can concussion symptoms be mistaken for anxiety?
Post-concussion symptoms and post-traumatic stress overlap a great deal. The events that cause one frequently cause the other. Poor concentration, irritability and disturbed sleep appear on both lists. So do light and noise sensitivity and low mood.
So there is a fork in the road, and people take it carelessly. Once the cause is pinned on psychology, the patient is treated for anxiety. Meanwhile a treatable vestibular or oculomotor problem goes unexamined for months.
Both can be true at once, and usually are. PTSD and post-concussion syndrome covers the overlap and how the two are told apart.
What the research actually shows
Post-traumatic stress disorder is measurably more common after a traumatic brain injury than after other injuries. Pooled civilian data put it around 12 percent at three months. It rises toward 19 percent at a year. The relative risk is substantially raised.
The heterogeneity between those studies is high. Their results differ widely. We say so rather than quote a single figure as settled. What is not in doubt is the direction. This is a real association, and it argues for assessing both rather than choosing between them.
Separating the two in practice
Vestibular and oculomotor testing does not depend on how someone feels about the event. Take convergence insufficiency, gaze instability and positional provocation. These are physical findings. They are either present or they are not.
Where they are, there is a physical injury to treat, no matter what else is going on. Where they are not, that is genuinely useful information too. It points the plan elsewhere. What the assessment involves.
What happens at a first concussion appointment?
About an hour. First comes a detailed history — including past head injuries, which most people have to be asked about directly. Then comes structured testing of the systems that produce persistent symptoms.
Vestibular testing. An oculomotor (eye movement) check that includes convergence. Balance. A symptom inventory that is scored rather than described. Cognitive screening. Where the timing is right, biomarker work.
You leave with an explanation of which systems are affected. You also leave with a plan aimed at those systems, rather than a general instruction to rest and review.
Can you drive after a concussion?
The questions people actually want answered are usually about driving, returning to work, and whether screens are doing harm. Those can be answered once the testing is done. Before it, they are largely guesswork.
Say oculomotor function is impaired. Then driving in low light or heavy traffic is genuinely harder. That is a physical finding, not nervousness. Say vestibular function is impaired. Then busy places bring on symptoms. A graded exposure plan works better than avoidance.
We give specific guidance with a set point to review it, rather than open-ended limits. That is because avoiding things forever has its own cost.
Can you work with a concussion?
Most people keep working in some form. Complete time off is rarely the right prescription beyond the first days. What matters is matching the mental and sensory load to what the person can handle right now.
For desk work, that usually means screen changes, planned breaks, and a quieter space where possible. For anything involving heights, machinery or driving, clearance is based on tested balance and reaction. It is not based on symptom report.
Second opinions
A fair number of people who reach us have already been told there is nothing wrong. That is worth taking seriously rather than dismissing, because sometimes it is correct.
What we can add is structured testing of the specific systems that produce persistent symptoms. That is frequently what was not done. If that testing is normal, we will say so plainly. That answer is worth having too.
If everything tests normal
That happens, and it is a real result, not a failure of the assessment. Normal vestibular, oculomotor and cognitive findings in someone with persistent symptoms redirect the search. They do not end it.
Sleep disorders, mood, medication effects, cervical (neck) sources and untreated pain elsewhere all produce this set of symptoms. Knowing the brain systems are intact lets those be looked at properly. Otherwise they get crowded out.
Bringing someone with you
Worth doing. Family and partners routinely notice things the patient does not — word-finding pauses, irritability, how much has quietly been given up. What they see is genuinely diagnostic.
It also helps with recall. Taking in a plan while you have symptoms is harder than usual. A second person hearing it makes the follow-through considerably more reliable.
Frequently asked questions
Could this all just be anxiety?
Anxiety after a head injury is common. It is not the whole story. Vestibular and oculomotor findings are physical, and they can be tested. That is how the two are told apart: PTSD and post-concussion syndrome.
Is a forty-five-minute drive worth it?
Maybe your symptoms have been blamed on stress without anyone examining the physical systems. If so, a visit that tests them changes the plan. If a local program is working, stay with it.
Do you treat the psychological side as well?
We assess it and treat what is within our scope. We refer where dedicated trauma treatment is the right answer. The two are managed together rather than one after the other.
How far is the clinic from Belleville?
Around forty-five minutes via IL 15 and I-255, or IL 159 and I-64, then north on I-170. Morning appointments travel considerably better from St. Clair County.
Which late concussion symptoms come up most often?
Five come up often: poor concentration, irritability, disturbed sleep, light and noise sensitivity, and low mood. Every one of them also appears on the list for post-traumatic stress. That is why they are so often put down to anxiety. Vestibular and oculomotor testing tells the two apart. Convergence insufficiency, gaze instability and positional provocation are physical findings. They are either present or not.
How long is a first concussion visit, and what does it cover?
One who tests the physical systems before deciding the cause. A useful first visit takes about an hour. It covers a detailed history, including earlier head injuries. It covers vestibular testing and an oculomotor exam including convergence. It also covers balance, a scored symptom inventory and cognitive screening. You should leave knowing which systems are affected and what the plan is. If the testing is normal, a good doctor says so plainly.
Getting here from Belleville
Concussion Center
4477 Woodson Rd, Suite 105, St. Louis, MO 63134
Monday–Friday, 8:00 AM – 5:00 PM
From Belleville, IL 15 west to I-255 north and I-64, or IL 159 to I-64 west, then north on I-170 — allow around forty-five minutes.
Related reading: concussion treatment for Alton, IL patients and concussion treatment for Edwardsville, IL patients.