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.

 

 

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.

 

What Are Symptoms Of A Concussion Or Brain Injury?

I often tell clients that they need to be on the lookout for brain injuries.   For some head injuries, the problems are obvious.  But in many cases, the problems are much more subtle.  As a result, many concussions or brain injuries go undiagnosed because a doctor doesn’t know you well and doesn’t see the symptoms.  Because of this, it’s important for you or your spouse or other family members to look for symptoms so you can convey that information to doctors.

Working on a case, I stumbled across this symptom chart from the Centers for Disease Controls that will help you identify potential brain injuries.  Hopefully, this will help you recognize problems so you can get the treatment and care you need.

Symptoms of concussion

Motor Vehicle Accidents: Do I have to provide a release of medical information to the insurance company?

We recently received an inquiry asking, “Do I have to provide a release of medical information to the insurance company?”

Generally, the answer is “no,” but for a more detailed answer, I need to know the type of case.

If you’re making a claim directly against the driver who caused the wreck, the answer is clearly “no.”  In that situation, we would almost never advise our clients to sign a blank release giving the insurance company full access to all of your medical records.  Instead, we’ll gather all of your medical records related to your wreck and forward them to the insurance company.

Now, once a lawsuit is filed, the insurance company will typically subpoena records from medical providers who you saw as a result of the wreck.  Additionally, if you have a history of a condition related to your injuries from the wreck, the insurance company might try and get your records from before the wreck.  But even in those situations, we’ll try and insist on a reasonable limit on what they obtain.

If you’re making a claim against your uninsured or underinsured motorist carrier or with your personal injury protection carrier, then you have a contractual duty to cooperate with the company.  If you don’t, you could be risking your benefits.  But even in those situations, when the insurance company asks for a release, we’ll try and work with them to provide a limited release.  For example, we might limit the release to those doctors who provided treatment from the wreck.  And if the insurance company wants past medical records, we might limit them to five years before the wreck.  The insurance companies will typically work with us to find some reasonable limits.

Again, there may be situations where you have a long-standing condition that makes things a little different, but for those most part, this is how we try and deal with requests for a medical release.

Head Injuries and Concussions — From Players’ Perspective

If you know me, you know I’m a huge University of Texas sports fan.  Because of that, I’m a huge fan of the Longhorn Network.  Usually, the stories just relate to my sports passion, but in light of David Ash’s retirement from football due to his repeated concussions, the LHN ran a great piece that talked with three former UT players about their battles with concussions.

Watching it, one thing that stood out to me was something that we see in our practice (and which the science backs up), and that is, once you have had a concussion (or multiple concussions), it takes a smaller impact to re-injure the brain.  Additionally, with a history of concussions, the symptoms appear to get worse.

If you have any interest in head injuries, concussions or sports, I highly recommend the story below.

Austin Bans Use of Hand-Held Cell Phones While Driving

Yesterday, the Austin City Council adopted a ban on drivers using hand held electronic devices, including cell phones.  The ban, to go into effect on January 1, 2015, doe contain exceptions for hands-free devices and for 911 or other emergency calls.  You can read more about the ban in this article by KXAN.

I have some mixed feelings about this.  On the one hand, I see these problems daily, and I preach about the dangers of distracted driving, including the curse of texting while driving, and, overall, I’m in favor of the ban.  On the other hand, I’m a bit concerned that this might be overreaching.  Talking on cell phones has become accepted, and it’s hard to legislate away such accepted conduct.

I hope the biggest effect of the ban is that we don’t have to see so many people texting while driving.  Police officers think the overall ban will make it easier to enforce existing texting while driving bans, and I certainly think that’s a good idea.

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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