Brain Injury Symptoms: Neurological Disorders (Seizures, Movement, Fatigue, etc)

The human brainAs I repeatedly tell clients, brain injuries often go undiagnosed following car wrecks or other accidents because doctors don’t usually know you well enough to make a pre-injury and post-injury comparison of your intelligence, emotional well-being, and general personality.  As a result, it’s often up to you or your family members to notice the symptoms of a brain injury and convey those to medical providers so you get the best care possible.  But to do that, you need to know the symptoms of brain injuries.  This series is designed to help you do that.

There are a number of neurological symptoms of brain injuries that, though sometimes rare, can be extremely traumatic for the injured person.  The most common neurological injuries are as follows:

Fatigue.  Fatigue is a very common symptom of people with brain injuries.  Some studies have found that up to 73% of persons with head injuries suffer from fatigue after the injury.   Unfortunately, many of the other symptoms of brain injuries, such as depression, also have a component of fatigue, and fatigue is also a side effect of many medications used to treat other brain injury symptoms.  Thus, treatment of fatigue remains difficult.

Post-traumatic seizures and epilepsy.  Seizures and epilepsy are fairly common symptoms of brain injuries.  Traumatic brain injury accounts for about 5% of all epilepsy cases and is the leading cause of epilepsy in young adults.  The development of seizure or epilepsy symptoms are very dependent on the type of injury sustained.  Many brain injury victims will undergo EEG testing to determine whether or not the patient is having seizures.  It’s important to note that a normal EEG does not mean that you don’t have a brain injury, it only means that you’re not having seizures at the time of the test.

Tremors. Many brain injury victims will develop tremors following their injury.  The most common cause of brain injury tremors is car wrecks where the brain has a history of quick deceleration injuries.

Dystonia (involuntary muscle contractions). Dystonia is a fairly rare, but significant symptom of brain injuries.

Vision problems.  Many brain injured patients have injuries to the optic nerve so the patients experience blurry vision or other changes to their eyesight.  There are other potential causes of sight issues associated with brain injuries that are discussed elsewhere in this series.

Smell problems.  Many brain injuries end up damaging the olfactory nerve so the victim will have an impaired sense of smell.  It is obviously difficult to test for smell issues, and smell is not something you might normally be concerned with after you’re injured, but if you or a loved one mentions smell problems, be alert that it could be related to a brain injury.

Vestibulocochlear nerve problems.  This nerve works on both hearing and balance.  Thus, when it is damaged as part of a brain injury, it can cause problems with hearing and also vertigo symptoms.  Vertigo is very common following a brain injury and a number of our clients have had to undergo vestibular therapy as part of their treatment.

Sleeping disorders.  Sleep-wake disorders and alterations in sleep patterns are very common following brain injuries.   The variety of sleep disorders include insomnia, excessive daytime sleepiness, narcolepsy, and sleep apnea.  Sleep issues need to be addressed because poor sleep can lead to other health concerns.

 

 

Brain Injury Symptoms: Behavioral and Emotional Symptoms

The human brain

INTRODUCTION

As I repeatedly tell clients, brain injuries often go undiagnosed following car wrecks or other accidents because doctors don’t usually know you well enough to make a pre-injury and post-injury comparison of your intelligence, emotional well-being, and general personality.  As a result, it’s often up to you or your family members to notice the symptoms of a brain injury and convey those to medical providers so you get the best care possible.  But to do that, you need to know the symptoms of brain injuries.  This series is designed to help you do that.

You may only realize that you or a family member has a brain injury because you notice changes in you or your family member’s behavior or emotional status.  Some of the common emotional or behavioral issues that we see from brain injuries are as follows:

Irritability.  Many survivors or friends of survivors find that the injured person is more irritable and much more easily angered.  The injured person may also have an angry response to a situation that is greatly out of proportion to what you would normally expect.

Impulsivity.  Many brain injury survivors have problems with impulse control.  They say things they wouldn’t normally say; they take physical actions they wouldn’t normally take; or they demonstrate poor judgment failing to fully think things out.

Affective instability.  Many persons with brain injuries show exaggerated displays of emotion that are way out of proportion to the situation or to the person’s pre-injury self.  As mentioned above, some persons become explosively angry at something that doesn’t seem justified.  Others may become extremely sad over something that doesn’t warrant such a response.

Apathy/Lack of Motivation.  Apathy is very common in persons with brain injuries.  One study has found that more than 60% of brain injury victims suffer some form of apathy.

Depression.  Some studies find that between 30 and 60 percent of brain injury victims have depression.  This doesn’t include the significant percentage of victims who experience some symptoms of depression, but not enough for a formal diagnoses.  Additionally, if victims had depression prior to their injury, a brain injury can make that depression much more severe.

Psychosis.  Psychosis is an infrequent (but high impact) occurrence with brain injuries.  Typical symptoms of psychosis might be delusions, hallucinations, or schizophrenia-like problems.  As I said, these are rare problems in brain injuries, but when they occur, they are very problematic for the affected person.

General Anxiety Disorder. Many brain injury victims describe feelings of anxiety.  If a person has experience anxiety before their injury, then they are much more likely to experience even worse anxiety after the injury.

Obsessive Compulsive Disorder.  A small percentage of brain injury victims develop OCD after their injury.

Post-Traumatic Stress Disorder.  There are a number of studies finding that victims of brain injuries are also likely to experience PTSD.  This is a problem that is being highlighted by the experiences of our soldiers in the middle east conflicts.  PTSD is also problematic because it makes recovery much more difficult.

Substance Abuse.  Several studies find that victims of brain injuries are much more likely to experience substance use disorders.

Dementia.  There are substantial studies finding that brain injuries both increase the likelihood that the victim develops dementia and also may result in earlier-onset dementia for those who are already pre-disposed to developing dementia.

 

Brain Injury Symptoms: Cognitive Impairments

The human brainAs I repeatedly tell clients, brain injuries often go undiagnosed following car wrecks or other accidents because doctors don’t usually know you well enough to make a pre-injury and post-injury comparison of your intelligence, emotional well-being, and general personality.  As a result, it’s often up to you or your family members to notice the symptoms of a brain injury and convey those to medical providers so you get the best care possible.  But to do that, you need to know the symptoms of brain injuries.  This series is designed to help you do that.

The fist set of symptoms that many people notice are the cognitive symptoms.  The major cognitive issues that are associated with brain injuries are as follows:

General Intelligence.  This is difficult to quantify without proper testing, but many people suffering from brain injuries feel that they have lost intelligence compared to their pre-injury intelligence.

Memory Issues.    The memory issues associated with brain injuries take many different forms.  The most common memory issues are post-traumatic amnesia, short -term memory problems (not remembering what you’re doing, not remembering your typical tasks, etc.) and long-term memory problems.

Attention Span and Working Memory.  Many victims of brain injuries also have more difficult paying attention to things, especially for longer periods of time, and they have difficulty with working memory — the short-term memory needed to process tasks.  These deficits can be tested through tests that show the person shapes or various patterns and then ask the person to recall those same shapes and patterns a few moments later.

Reaction Time.  Numerous studies have found that persons with brain injuries have a slower reaction time to different events.  The reaction time becomes worse when the task is more difficult, the person has more information leading to information overload, or the person is fatigued.  Again, this is a symptom that is difficult to quantify without proper testing.

Spatial Cognition Issues. Brain injured persons might recognize spatial cognition issues in terms of getting lost, not remembering where objects were placed or put, and not understanding directions.

There are other cognitive issues that can arise, but these are the most popular that we see.  Unfortunately, one problem of brain injuries is that there is a well known phenomena that injured persons are often unaware of these deficits.  Therefore, it’s critically important that friends or family members pay attention for these symptoms.

 

 

 

Brain Injury News: Ohio State Football Player Found Dead After Head Injuries

The human brainThere was tragic head injury-related news out of Ohio this weekend.

Yesterday, two individuals sifting through a dumpster in Columbus, Ohio found the body of Ohio State football player Kosta Karageorge, who had apparently committed suicide.

Karageorge had been missing since Wednesday.  Earlier that day, he sent an ominous text message to his mother that his concussions have his head messed up, he left his apartment, and he had not been seen since then until his body was discovered.

I hope that Karageorge’s death is not in vain, but that he serves as a reminder of the importance of getting good mental health care following head injuries.  I often see people who have head injuries get a double dose of the mental anguish problem.

First, people with head injuries experience the confusion and mental health problems that result from the actual injury itself.  These symptoms can be severe and debilitating.

But head injuries are also an invisible problem.  With a broken arm or leg, friends and family members can see the injuries and can understand when you are hurt.  But head injuries aren’t like that.  Often, in addition to going through the stress and emotional consequences of the injury, injured persons also suffer additional emotional trauma from their friends and family members not really understanding that they’re hurt or the extent of their injuries.  This can only compound the problem.

If you or a loved one has sustained a brain injury, learn from this tragedy, and get the therapy or other assistance that you need.

 

 

Campus Rape Crises

As the father of a high school girl, the statistics about campus rape and sexual assault rates that scare me to death.  But the stories behind the assaults are much more troubling than the mere numbers.

This isn’t something that I would normally write about here, but it is something that is on my mind and something that I feel needs to be shared.

This week, Rolling Stone magazine released an article, A Rape On Campus: A Brutal Assault and Struggle For Justice At UVA, looking at the problems at the University of Virginia, and it is a compelling read on a huge problem. I think all parents should read it.

Unfortunately, this doesn’t appear to be an isolated event.  I did a simple Google search on “Campus Rape” and came up with too many stories and resources to count.  If you’re interested in reading more about the problem, some of the resources are:

In part, I’m encouraged that a conversation is starting in the country.  Perhaps that can help alleviate the problem.  I’m also heartened that lawyers are helping hold people and schools accountable in the process.

But I’m also disheartened by many of the things I’ve read, particularly in comments to articles:  people blaming the victims, people denying that a problem exists, etc.

I hope that colleges and universities and others take these matters seriously to protect my daughter, her friends, and others.

Posted on: November 25, 2014 | Tagged

What Should I Do After An Injury?

The most important thing you can do after your injury is to get the medical care that you need.  This is important on two grounds.  First, it’s obviously important for your health.  Going to the doctor as soon as possible gives the doctor an opportunity to either provide treatment or to send you to a specialist.   Going to the doctor and following the advice of your doctors is probably the most important thing to do to get better.

Second, going to the doctor(s) and following your doctors’ advice is important for your personal injury claim.  For a lot of insurance companies, your claim will be penalized if you don’t get to the doctor early, have a gap in treatment (fairly long time periods between doctors’ appointments), or you don’t follow your doctors’ advice.

The next thing you should do for your claim is to talk to a personal injury lawyer early.   There are several things that we can help you with early in the process that can affect the value of your claim.   If you wait until later to hire a personal injury lawyer, you’re potentially missing out on several steps that will likely affect the value of your case.

 

Posted on: November 24, 2014 |

May I Fire My Texas Personal Injury Lawyer?

firedWe frequently get contacted by injured persons wanting to know if they can fire their personal injury lawyer.

The short answer is “yes, you can fire your personal injury lawyer even if you’re paying a contingent fee”, but you still may end up paying the first lawyer.  Let me explain.

Texas contingent fees are governed by a 1969 Supreme Court case of Mandell & Wright v. Thomas.    In that case, the Court stated that when a client fires a lawyer who is working on a contingent fee without having good cause, then the lawyer can still recover the full contractual fee.

This means that if you have hired a lawyer and agreed to pay him 40% contingent fee, decide to fire the first lawyer and hire a second lawyer on an identical 40% contingent fee, then you could be paying 80% of your claim for attorneys’ fees.  So yes, you can fire your lawyer, but if you’re not careful, you could end up paying for that decision.

Having said that, these issues can usually be worked out.  When you call us and ask us about firing your current personal injury lawyers, the first advice is almost always to schedule an appointment with the prior lawyer, sit down face to face, and see if you can’t work through your differences.  In many cases, disputes are often just a misunderstanding, and communication between you and the lawyer can help both of you move forward.

I realize that can’t work in all cases.  For a variety of reasons, you might not be able to work with your current lawyer.

In most cases, if you simply can’t work with your prior lawyer, then we can try to work something out with the prior lawyer so that you’re not being charged two fees.   Sometimes, the prior lawyer may agree to give up his rights to the fee and expenses.  Sometimes, the prior lawyer may agree that he won’t collect a fee, but he would like to be reimbursed for his out-of-pocket expenses incurred in your case.  And in other cases, we will work something out with the prior lawyer to share the fee so that you are only charged one fee.  The particular circumstances in your case will dictate what agreement can likely be reached.

However, there are times when we’ll talk to your prior lawyer, and we can’t work out any agreement.  Those instances are difficult.  Depending on the circumstances, we may advise you take various steps, including investigating whether you might want to file a fee dispute with the Austin Bar Association Fee Dispute Committee.  Regardless, if we can’t work something out with your prior attorney, we will typically not take your case until that issue is resolved because we don’t want to be part of a matter where you might be paying two fees.
So long and short, yes you can fire your personal injury lawyer, but the best way to do it is to do it as amicably as possible to minimize the risk that you might have to pay extra attorneys’ fees.

Posted on: November 19, 2014 | Tagged

People Continue To Text And Drive

text messaging while drivingA new texting while driving survey done by AT&T found that 98 percent of motorists who text regularly know the dangers of texting while driving, but 75 percent of them admit texting while driving anyway.

That’s not surprising, in our practice, we regularly see people who are seriously injured because of people texting while driving.

The good news is that we’re finally seeing some things done about it.  The study results were released as part of an effort by AT&T to publicize a new phone app for AT&T customers that silences text message alerts and activates automatically when a person is moving 15 miles per hour or faster.    The DriveMode app will be coming to iPhones shortly and will soon be available to other carriers.

 

 

Concussions — IMPACT Testing For Kids

My son sustained a concussion last spring while playing baseball.  During that process, my son took a test called an IMPACT test to help diagnose the concussion and to help figure out when he had recovered sufficiently to return to normal activities. But our problem was that we didn’t have a baseline.  The IMPACT test works best if the kids have taken a pre-injury test (required by many school athletics departments) to be compared to the post-injury tests.  Since the pre-injury test only costs around $20, I’ve become a big proponent of encouraging kids to take the tests.

Recently, local news station KXAN ran a good story about the tests.  If you have kids, especially those participating in sports, I urge you to watch the story and to have the kids take the test.  You can watch the story below.

 

In Texas, No Justice For The Injured

The folks at Texas Watch have put together this great story on Texas’s medical malpractice reform.

Perlmutter & Schuelke, LLP maintains offices in Austin, Texas. However, our attorneys and lawyers represent clients throughout the state of Texas, including Dallas, Houston, San Antonio, Forth Worth, El Paso, New Braunfels, San Marcos, Kyle, Buda, Round Rock, Georgetown, Lockhart, Bastrop, Elgin, Manor, Brenham, Cedar Park, Burnet, Marble Falls, Temple and Killeen. By Brooks Schuelke

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