Neuroendocrine Dysfunction in a Young Athlete With Concussion: A Case Report
David M Langelier1, Gregory A Kline, Chantel T Debert
1*Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada; and †Division of Endocrinology, Department of Internal Medicine, University of Calgary, Calgary, AB, Canada.
Summary
Persistent concussion symptoms in athletes may signal neuroendocrine issues like growth hormone deficiency. Early diagnosis and growth hormone replacement therapy can lead to full recovery.
Area of Science:
- Sports Medicine
- Neuroendocrinology
- Neurology
Background:
- Persistent post-concussion symptoms can significantly impact an athlete's quality of life and performance.
- Neuroendocrine dysfunction is a potential but often overlooked cause of prolonged concussion-related symptoms.
Observation:
- An 18-year-old athlete presented 27 months post-concussion with fatigue, headache, exercise intolerance, polyuria, and concentration difficulties.
- Initial neuroendocrine screening was normal, but further testing revealed severe growth hormone deficiency and partial diabetes insipidus.
- The patient had a history of four prior concussions.
Findings:
- Severe growth hormone deficiency was diagnosed via insulin hypoglycemia testing.
- Partial diabetes insipidus was suspected due to borderline electrolyte levels.
- Neurologic examination findings were unremarkable.
Implications:
- This case underscores the necessity of considering neuroendocrine abnormalities in athletes with chronic post-concussion syndrome.
- Timely recognition and treatment, such as growth hormone replacement, can effectively resolve persistent, nonspecific symptoms.
- High index of suspicion for neuroendocrine dysfunction is crucial for comprehensive concussion management in athletes.
