Post-Concussional Syndrome

There’s a lot of argument over whether this condition really exists.

It describes a constellation of symptoms that go on for weeks to months following a mild concussive closed head injury.  It seems to happen in about 2% of people who have these sorts of injuries.  It seems to be a problem of filtering out unwanted sensory information.

Typically the person has the usual symptoms of concussion – nausea and vomiting, headache, dizziness, drowsiness  which resolve over 2-7 days.

The post-concussional syndrome describes persistence beyond this time of:

  • Headaches
  • Dizziness
  • Fatigue
  • Irritability
  • Insomnia
  • Impaired Concentration and Memory
  • Noise and Light Sensitivity
  • Tinnitus
  • Blurry Vision
  • Rarely decreases in taste or smell

MRI Scans are normal.

Neuropsychological Tests that test Frontal Brain Function such as the Continuous Performance Test or Train Making Test are usually abnormal.

The Differential Diagnoses are:

  1. Migraines
  2. Benign Positional Vertigo  –   Needs  ENT opinion
  3. Cervical Vertebral Trauma/Whiplash –   Needs Neurosurgical Opinion
  4. Anxiety Disorder
  5. Somatoform Disorder

Management

The steps in management are:

  1. Restoration of quality sleep pattern
  2. Developing a graded exercise programme
  3. Use of low dose anti-anxiety/anti-irritability medication
  4. L-Methyl Folate and Gurana are sometimes useful for fatigue
  5. Gamers Glasses (available through Amazon) are helpful for light sensitivity
  6. Relaxation music can be used to entrain noise intolerance.

 

 

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