What Are The Long Term Effects Of Post-Concussion Syndrome?
Immediate symptoms of concussion or mild traumatic brain injury usually resolve after a few days. However, in some sufferers, these symptoms persist long after the injury with a period that can range from weeks to months (or even years). This is a condition known as post-concussion syndrome (PCS).
According to the Harvard Medical School, PCS is more common among women than men. Individuals who have previous mental health problems prior to head injury, individuals who experienced traumatic stress (such as veterans, service members, military), and athletes exposed to recurrent head trauma are more likely to develop this condition. It’s not uncommon to misdiagnose PCS in people with chronic pain, PTSD, anxiety and depression because of the non-specificity of its symptoms. As such, accurate diagnosis is vital to its immediate and holistic rehabilitation.
Post-concussion syndrome affects at least three of these domains:
- Physical (balance problem, dizziness, fatigue, headache, and noise sensitivity)
- Emotional (feelings of anxiety, irritability and sadness)
- Cognitive (problems with short-term memory)
- Sleep pattern (insomnia, lack of sleep, excessive sleepiness)
- Excessive worry over symptoms
- Intolerance for alcohol
PCS symptoms are often recurrent and can greatly affect the quality of life.
Rehabilitation of post concussion syndrome
Getting enough rest and minimizing stress are necessary to treat post-concussion syndrome but rehabilitation requires more than rest and stress management.
People who are suffering more severe symptoms of PCS require more intensive medical, psychological and psychosocial rehabilitation. The use of psychotherapy and antidepressants along with medications to treat symptoms are a mainstay.
Complex cases, however, may be referred to a network of specialists that will help explore and understand the condition better and recommend additional care needed. Rehabilitation of post-concussion syndrome may vary depending on the symptoms experienced by the individual. Some possible rehabilitation programs that a PCS sufferer may undergo include:
- Visual rehabilitation – if the concussion includes visual symptoms such as blurred or double vision
- Vestibular and motor coordination rehabilitation – if there is an ongoing or recurrent balance and coordination symptoms
- Cervical proprioceptive training – if injuries to the neck resulted in visual disturbances, neck problems or incorrect neck sensations of position
- Cognitive behavioral therapy – this rehabilitation program seeks to address behavioral and psychological symptoms due to the PCS
- Neurocognitive rehabilitation – PCS sufferers who have attention, memory and executive symptoms may be recommended to undergo this rehabilitation program
- Monitored aerobic exercise programs – increased blood flow and oxygenation to the brain is essential for optimum healing and recovery as well as restoring the normal cerebral blood flow
- Medication – various medications may be prescribed depending on the symptoms presented by the individual; for instance, analgesic may be prescribed for headaches, antidepressant for depression, etc.
Rehabilitation of post-concussion syndrome requires a holistic approach to fully address the symptoms of the individual. Recently, studies have shown that medical acupuncture or the use of low level electrical nerve stimulation can help minimize PCS pain and other symptoms. DC electroacupuncture has shown very promising results for individuals suffering from PCS. While this adjunctive therapy is not yet considered a mainstream treatment, it can help a PCS sufferer during the long rehabilitation process.
All said, PCS sufferers develop changes in emotional, physical, behavioral and cognitive facets of their lives, and thus require high-quality, multi-faceted rehabilitation. Throughout the rehabilitation process, repeated evaluation of cognitive status and physical symptoms are done to guide the management of the condition. Lastly, the use of various strategies is essential to achieve enduring results – with an end-goal of bringing back the individual to a normal, healthy life.
How To Live With Post-Concussion Syndrome?
Living a life with post-concussion syndrome isn’t easy. But aside from the recurring symptoms, the thought of having a deeper, serious brain problem is even more disturbing. Not to mention, the countless myths about post-concussion syndrome.
For instance, not allowing a person suffering from concussion to sleep is a common medical misconception. A lot of people believe that allowing a person to sleep after a head injury might result to a coma or unconsciousness.
The term concussion originated from the Latin word “concusses” which means shock. In neurology, concussion is defined as a “trauma-induced alteration in mental condition”. It is experienced after having a slight head accident and it may last for weeks or months. Symptoms of post-concussion syndrome include headache, grogginess, sensitivity to light and noise, psychological problems such as anxiety and irritability and mental difficulties like concentration and memory.
Can concussion lead to sleep problems?
Yes. Post-concussion can lead to altered sleep pattern. A high rate of daytime excessive sleepiness among post-concussion patients has been recorded. While rest can help the brain heal faster, too much sleepiness during the daytime can pose a problem since it inhibits productivity in the workplace or at the school.
Meanwhile there are also others who experience the exact opposite — insomnia or difficulty or trouble remaining asleep. People with insomnia experience disturbances in the middle of sleep, preventing them from having a good rest. Delayed sleep phase syndrome or sleeping patterns is also a usual effect of concussion.
Everyday life with post-concussion syndrome
Living with post-concussion is both challenging and frightening. A day in a life of a person with post-concussion syndrome does not pass without experiencing, dizziness and headache attacks. Sometimes headaches are bearable but sometimes headaches can be severe.
More serious cases can even result in bouts of severe headaches and other more complicated problems. One could experience blurring eyesight, especially if the accident affected nerves responsible for the sense of sight. The most challenging part of having post-concussion syndrome is that it affects one’s daily social interactions.
Individuals with PCD may have difficulty socializing with others. Maintaining a conversation with other people comes tough because staying focused on the discussion is hardly achieved. The brain finds it hard to concentrate on a single matter. More than this, long term and short term memory are both affected.
Ways to treat post-concussion syndrome
- Vestibular physical therapy
There are several strategies to cure concussion syndrome. Vestibular rehabilitation therapy (VRT) is a good starting point in remedying usual post-concussion effects. Vestibular rehabilitation therapy is a program, which requires physical as to lessen dizziness and visual imbalance. This therapy basically helps the brain to get back to its proper functioning condition after experiencing trauma. VRT is composed of three key exercises – habituation, gaze or visual stabilization and balance training. Habituation exercise cures dizziness by familiarizing the person to specific scenes that triggers dizziness. Gaze stabilizing exercise repairs eye movement control to have a clear vision despite head movement. Balance training develops physical composure to avoid falling and improve mobility. For better efficiency, perform complete medical assessment to tailor fit vestibular exercises needed.
Today, there is no single drug that cures all the effects of concussion. Doctors usually prescribe separate medications for each of the symptoms. Dosage varies per person. Gabapentin (Gralise, Neurotin) is the painkiller usually recommended for headaches or injuries. For migraine-type headaches, as well as dizziness and irritability, Amitriptyline is frequently suggested. Topiramate is also another drug that threats migraine. These three are only some of the many drugs used to cure the symptoms of post-concussion syndrome. These drugs have been proven effective but consulting a physician before taking in medication is always advisable.
- Micro current therapy
One recent treatment regimen that has shown promising results for post-concussion syndrome is the micro current therapy. In this scientifically backed non-invasive procedure, DC electroacupuncture sends minute electrical nerve stimulation to the brain. These electrical impulses mimic the biochemical nerve stimulation. Studies have shown that DC electroacupuncture can lead to a significant improvement in the PCS symptoms and pain levels. This therapy is very much successful that its application for other conditions is also being carefully evaluated.
How to Treat Post-Concussion Syndrome
The Long-Term Effects of Post-concussion Syndrome
A single incident that causes concussion doesn’t usually result in long-term effects to the brain. But the caveat: the brain needs heal completely.
While concussion rarely results in long-term effects, a very small percentage of sufferers experience post-concussion syndrome. The recurring symptoms of concussion may develop a week after the brain injury and may linger for several weeks, months or even years.
Post concussion syndrome long term effects?
People suffering from post-concussion syndrome can experience cognitive, physical, and emotional problems that include irritability, headache, problems with short-term memory, difficulty concentrating, and dizziness. Others feel a sense of not being “normal” or a bit “slower” overall.
Long-term effects of post-concussion syndrome can be significantly disabling and greatly alter day-to-day lives. It can result in an inability to complete work or attend school and even interact socially with others. Worrying about a deeper, more serious brain problem can even worsen the problem.
How long does post concussion syndrome last?
Due to the non-specificity of symptoms of post-concussion syndrome, it is often very hard to predict how long the symptoms would last and even prognosticate its outcome. According to studies, most cognitive deficits would normally resolve within 1 to 3 months after the concussive injury. By this time, the brain should have healed completely and concussion-like symptoms should not be experienced. But in some sufferers, post-concussion symptoms persist beyond this period. In a different study published in the Journal of Neurotrauma, two-thirds of patients reported to have recovered from the symptoms within a year.
In some cases, the underlying cause of the prolonged symptoms is not really the concussion. Some may have pre-existing conditions like migraine headaches or clinical depression that can be mistaken as post-concussion syndrome. So, it is a challenge for doctors to know the real underlying cause of the symptoms.
Moreover, the body’s capacity to heal also plays a role on how long the post-concussion syndrome will last. Some respond well to rest while others require medication and other adjunctive therapies.
Is post concussion syndrome recovery possible?
The same study published in the Journal of Neurotrauma also revealed that recovery from post-concussion syndrome is possible. In patients who reported symptoms that lasted 3 months, about 27% eventually recovered within a month’s time, while 67% recovered within a year. The remainder who did not fully recover from post-concussion syndrome after a year was more likely to be non-compliant to prescribed therapy and/or experienced repetitive concussion events even during treatment period.
The recovery period is also dependent on the number of symptoms reported. The more symptoms the patient experiences, the longer the recovery will likely be.
Moreover, the study showed that post-concussion syndrome may be permanent if recovery has not occurred by 3 years. Long-term studies to examine recovery from the syndrome and rehabilitation therapy may be needed.
Post concussion syndrome test
Diagnosing post-concussion syndrome is often a challenge. There is no single diagnostic test that can fully diagnose this condition. Usually, the doctor will diagnose based on your symptoms. You may also be subjected to a series of physical examinations and diagnostic tests that focus on your nervous system. If you have post-concussion syndrome, the physical examination will likely yield no signs of problems with your nervous system.
Other tests may also be conducted such as CT scan or an MRI Scan. This is to ensure that there are no other underlying causes for your symptoms.
Post concussion syndrome treatment
There remains no specific medication or treatment modality for post-concussion syndrome. Usually, treatments are recommended based on the symptoms of the patient. However, there are several things that you might find helpful:
- Allow full recovery. Individuals who suffer from post-concussion syndrome are advised to take rest when symptoms recur and slowly return to their usual activities.
- Get adequate sleep. It is important to get good sleep hygiene. Get at least eight hours sleep and stick to a regular schedule.
- Medications to manage symptoms. Your doctor may prescribe some medications to treat your symptoms. These include analgesics for headache, antidepressant, medication for nausea, and others.
- Avoid stress and alcohol. This would greatly help your brain recover faster.
If symptoms persist and become particularly troublesome, your case may be referred to a specialist. They may conduct further examination.
There are also various therapies and treatment strategies that can help hasten your recovery. Direct-current electroacupuncture (DC-EA) is one treatment modality that has shown great impact for patients suffering from post-concussion syndrome. A case study reveals that it can help relieve pain and symptoms associated with post concussion syndrome. It works by mimicking the bioelectrical impulses of the body and working through the Autonomic Nervous System thereby resulting in therapeutic benefits. This adjunctive therapy may be used alongside other treatments. It can help manage prolonged effects of post-concussion syndrome.
An Overview of Post-Concussion Syndrome and 3 Ways to Treat it Effectively
Traumatic brain injury or TBI refers to an acute event that leads to either minor or major injuries to the brain. No two, brain injuries are the same. Some can lead to minor effects without symptoms while severe cases of TBIs can have a dramatic impact on a person’s life. Every year, over a million of people suffer from TBIs due to accidental fall or trip, taking part in sports or other recreational activities, and being involved in a road accident. TBI contributes a substantial number of cases of permanent disability and deaths.
Concussion is among the most common but less serious types of TBIs. This condition results from a violent blow or blunt force applied to the head causing a sudden disruption in the Reticular Activating System (RAS) in the brain. Located in the middle of the brain, the RAS helps regulate the sense of consciousness and awareness. It is also plays a role in helping you focus on details while ignoring unimportant information. These tasks include waking up on time, falling asleep, instantly focusing on items that interest you, etc.
In head injury that results in concussion, your brain is jolted or moved out of its normal position in a short period of time. This leads to a disruption in the electrical activities of your brain cells, particularly the RAS. Some of the common symptoms of concussion include pain, loss of memory, mental confusion, and a short period of unconsciousness. However, some people may experience none of it.
When symptoms don’t resolve
Usually, symptoms of concussion settle within hours, days, weeks, or at most months. However, some may also experience unique symptoms depending on the part of the brain that got affected. For example, a person may report blurred vision if the part of the brain that directly processes visual information gets affected.
But while the brain has an awesome ability to recover, some sufferers develop a complication known as Post-Concussion Syndrome. In this condition, the symptoms of the brain injury persist for longer than usual. The symptoms can only get worse over time that can adversely affect your life. Chronic pain has known to be a result of post-concussion syndrome.
Looking at post-concussion syndrome
After an injury, the ‘volume knobs’ inside the brain are turned up resulting in symptoms like dizziness. Additional sensory and pain signals can get past the brain, which would normally filter it out. Once the brain is recovered, these ‘volume knobs’ are slowly turned down and the ‘brain filters’ resume work. But that’s not the case in post-concussion syndrome. It’s the other way around. The ‘volume knobs’ are further increased and become more active over time.
Some are afraid that the symptoms could be a sign of a form of brain damage. But the truth is that these symptoms don’t often reflect major complications in the brain. In fact, it is the worrying part that can worsen your condition. These functional neurological symptoms such as chronic pain, dizziness, fatigue, sleep disturbance, anxiety, headache, and poor concentration can have a profound impact on one’s daily fare. As such, it is important to find a way to effectively manage post-concussion syndrome.
Treating post-concussion syndrome
Managing post-concussion syndrome requires several aspects.
- First, you have to understand the right diagnosis. Some may dwell in the idea that they have far more serious brain damage due to the injury, which would likely hinder the recovery. By understanding that the symptoms are reversible, you are able to rehabilitate faster.
- Second, treat the symptoms with conventional treatment. For instance, if you are experiencing headache or pain, take medications for headache. If you have psychological symptoms, such as anxiety, nightmares or depression, you can work with your doctor for specific treatments. You may be evaluated for possible post-traumatic stress disorder.
- Thirdly, with the approval of your doctor, you can attempt adjunctive therapies such as medical acupuncture. This procedure is known to help sufferers by tapping directly into the brain’s autonomic nervous system (ANS). When applied to trigger points, it sends concentrated, low frequency DC micro-current stimulation for optimal pain relief. It also helps release scar tissue and adhesions. Overall, it’s a simple, non-invasive and effective treatment for post-concussion syndrome pain.
In this the patient receives DC-EA treatments, which are applied bilaterally to previously identified acupuncture-trigger points, which are along the cranial surgical scars. Two Dolphin Neurostim devices, at a low frequency, introduce concentrated micro current stimulation at 30-second intervals. One side is set to a negative pole while the second device is set to positive-negative pole to push a negatively charged current through the scar tissue.
After the treatment the patient reports a zero pain level with a light touch to the top of the head, and six months later the headaches and the tremors are completely cured.