Introduction

Developmental functional neuroscience is an approach within healthcare that promotes the use of various methods to stimulate physical receptors within the body in order to produce positive neuroplastic change in the nervous system. Dr. Robert Melillo has been the main pioneer of this work and has created and trademarked the Melillo Method, which outlines examination and therapeutic procedures specific to the developmental trajectory of the individual being treated. The goal of developmental functional neuroscience is to bring balance to the nervous system in order to improve the overall mental, physical and chemical state of the individual. This approach promotes healing for all types of ailments and conditions since the approach is not diagnosis driven, but rather is based on the specific needs of the individual at the time of examination. This approach has been researched in various instances and found to be safe and effective; see (1) Melillo et al November 17, 2020;(2) Leisman, Melillo et al April 5, 2015; (3) Leisman, Mualem, Machado July 25, 2013; and many others.

Photobiomodulation defines the use of various forms of light therapy to evoke abiochemical change within a living organism. Photobiomodulation is the term that has been accepted by the North American Association of Photobiomodulation Therapy (NAALT) that defines the use of non-ionizing light therapy in the form of lasers, LED's, and / or broadband light sources in the visible (400-700 nm) and near-infrared (700-1100 nm) electromagnetic spectrum. It is a process that involves exciting endogenous chromophores that create photophysical and photochemical events within biological systems. Essentially the term can be broken down as: Photo= light; Bio = life; Modulation = to alter, change or adjust; therefore, the term literally means to change life with light. Chromophores are receptors for light that are scattered all over the outside and inside our body. Each chromophore responds differently depending on the wavelength of the light. There are chromophores that control our circadian rhythm and chromophores that produce more ATP within our cells; there are many different types that have various biological effects. Photomedicine goes back over 3000 years ago around 1400 BC in India where they would employ the use of sunlight to treat various ailments.

Beginning in the 1700's doctors began to use forms of light therapy to treat infections such as tuberculosis and others, ulcers, cancers and other internal maladies. It was also noted how much the light therapy accelerated wound healing. This really marked the birth of photobiomodulation and it's use in modern medicine. Albert Einstein was a leading pioneer in the field of photobiomodulation. He was actually awarded a Nobel Prize in Physics for defining the law of the photoelectric effect. The photoelectric effect occurs when photons collide with electrons at the atomic level; this causes the electrons to either jump into a higher orbit or causes them to be emitted or ejected from their orbit. This process allows for more energy to be emitted and absorbed by the surrounding matter; thus raising the voltage of the tissue which speeds up healing. Photons are the smallest measurable unit of light; they are defined as massless packets of energy or quanta. The energy of the photon depends on its wavelength and is measured in electron volts (eV). For example a red photon has about 2 eV of energy where a blue photon has about 3 eV of energy.

Hypothalamic storming, also known as hypothalamic-mesencephalic dysfunction or autonomic dysfunction syndrome, is characterized by hyperthermia, tachycardia, hypertension, tachypnea, pupillary dilation, increased extensor posturing, and diaphoresis. This is a very common presentation for those that have suffered an anoxic type brain injury. The reason for this is that there are specific areas in the brain that are more prone to injury from anoxia because these areas are supplied by several small capillary beds. These areas are defined as watershed zones and include but are not limited to the lenticulostriate arteries, known as the lenticulostriate watershed zone. This area represents a major confluence of several arteries and is broken down into various small capillary beds that supply very intimate parts of the brain and brainstem. The lenticulostriate arteries supply the midbrain and thalamus among other structures, which are the areas heavily affected in hypothalamic storming. There is currently no medical treatment that has been proven highly effective for hypothalamic storming. The most common treatments include a cocktail of medications that offer little to no relief in the majority of cases.

Summary of Patient Presentation

Gender: Assigned Male at Birth
Date of Birth: November 29, 2019
Date of Exam: September 20, 2021
Date of Accident: March 3, 2021
Accident Type: Near fetal drowning

Presents with severe extensor tone and posturing. Patient was crying for the majority of the exam.  No voluntary movements present. Patient presented with moderate diaphoresis, pupillary dilation bilaterally, tachycardia and tachypnea. Left hip dislocated and right hip subluxated due to posturing tone. Both knees are hyperextended, right more than left; left leg externally rotated.

Parents report sleeping trouble; will go to sleep at 7:30 - 9:00 pm then wake up at midnight crying and storming. Typically does not sleep more than 2-3 hours at a time.

Seizure activity that presents as a cross torquing of the torso to the left; these events are typically triggered when he's more relaxed and trying to fall asleep and there is a noise that startles him. During these events they will see his eyes cross and a vertical nystagmus.

Parents report a diagnosis of gastritis and that he will have 1 - 4 bowel movements per day.

Primitive Reflex Evaluation (graded 0-4 with 4 being most positive)

• Rooting: 4
• Palmer: 4 (wears wrist braces at times and this calms him down)
• Babinski: 4
• Tonic Labyrinthine: Could not perform
• Asymmetric Tonic Neck Reflex: 4, presents with dominant right head rotation
• Symmetric Tonic Neck Reflex: 4
• Moro: 4
• Fear Paralysis: 4
• Spinal Galant: 4, difficult to test due to extensor tone
• Spinal Perez: 4, difficult to test due to extensor tone

Postural Reflexes

• Parachute: Not present
• Propping: Not present
• Head Righting: Not present

Facial Tone

• Reduced tone right side of face

Cerebellar Tests *Could not perform

Eyes

• Pupils: dialated bilaterally, right larger than left
• Maddox Rod Evaluation: Could not perform; but eyes typically stay looking to the right
• Gaze Fixation: could not evoke, was crying and posturing too much
• Optokinetic Reflex: Difficult to evaluate, saccadic hypometria noted in all directions

Other interventions prior to beginning care with The Austin Center for Developing Minds:

• Hyperbaric Oxygen Therapy performed with Dr. Harch, MD - reported that they completed 25 dives, but then storming increased so they ceased care. This may have also been related to the initiation to wean Onfi medication while performing dives. They do also have a home HBOT chamber and they do typically see an increase in storming and absent seizures when they perform home HBOT dives.
• Stem cell therapy performed with Dr. Kenneth Proefrock, NMD coupled with intramuscular hylauronidase injections.
• Rx medication at time of exam included Artane, Baclofen, and Gabapentin.

Methods of Intervention used at The Austin Center for Developing Minds:

• Intensive program of 10 days of consecutive care, with a weekend break of Saturday and Sunday mid way through care. Average of 4 hours of care per day.
• Melillo Method therapy approach focusing on the right hemisphere and integration of primitive reflexes referenced above.
• Vagal system integration therapy. We mainly targeted the vagus nerve and the ventral vagal system via therapies such as cymba concha / auricular branch of the vagus nerve stimulus and facial stimulus. We used vibration and electrical stimulus in these areas.
• Photobiomodulation using the Avant LZ30-Z laser with proprietary NeuroSolutioin settings and methods. We typically used four lasers at a time both on the 637 nm wavelength with a power of 1000 mW and the 808 nm wavelength with a power of 1400 mW. We used the lasers in the following ways: NeuroSolution blood illumination protocols over the carotid and abdominal aortas, laser therapy over neurological deficits as defined by exam, laser therapy over all major muscle groups, laser therapy over spine, laser therapy over the abdome / gut.

Methods and interventions were very well tolerated and no major adjustments to treatments were necessary throughout the intensive program. At the conclusion of the intensive program a specific home care plan was given based on the patient's needs and advised on with parents so to continue therapies at home.

At the end of the intensive therapy program parents have reported a 100% reduction and elimination of hypothalamic storming symptoms. This was apparent immediately after the program and is still true at the time of this case study being written on December 30, 2021. Parents report that they also see benefit from a supplement that was compounded by Dr. Proefrock consisting of L-Threonine and Zinc Carnosine.