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  • Memory and Attention Impairments. By Mariel C.

Post-Concussion Syndrome

Post-Concussion Syndrome

Following a concussion—including from whiplash—there is a long list of symptoms which are identified as “Post-Concussion Syndrome” (PCS). Changes in cognitive functioning is the longest lingering effect, and most PCS patients complain of mental fog, poor recall, word-finding difficulty, and inability to focus on their work and other tasks. Some of my patients report missing their freeway exits, being distracted at work or school, and perseverating on a task (i.e. washing the same area repetitively without realizing it). This is not the typical “auto pilot” mode. It can be dangerous and can become a job retention issue.

The problem with undiagnosed PCS is that it goes untreated and may persist for years becoming Persistent PCS (PPCS). A student or worker with PCS is at risk for failing or losing their job, becoming anxious and/or depressed because they know they used to be able to function more efficiently, but now things are different but without medical acknowledgement. On top of this, there may be changes to personality and mood. The typical complaints reported by patients’ families are clinginess, being irritable, easily frustrated and isolative.

Patients with PCS will often report feeling invalidated and don’t understand why a mild head injury is having such debilitating effects despite their doctors telling them they are “OK.” Many have trouble sleeping and are mentally and physically fatigued before noon. It is important to understand that when a brain has been injured, it works even harder to rewire new pathways for processing information (depending on the areas that were injured). Post-trauma brain CT scans show how many areas of the brain are over-stimulated as compared to an uninjured brain performing the same activity. Rest is often recommended after a concussion, however, it can perpetuate the psychological symptoms of PCS. 1

An in-depth PCS therapy evaluation by a neuro-specialized occupational therapist (OT) will include assessment of their patient while engaged in self-care and work tasks that have been impacted by their brain injury in order to minimize overstimulation and distractions in their environments. OT interventions provide practical and effective solutions for managing symptoms and correcting some of the cognitive dysfunctions associated with the head injury, such as:

• The patient’s energy and strength for task initiation and completion

• The importance of good sleep habits

• Daily schedules to facilitate optimal functioning for home chores, work and school

• Adaptive equipment and compensatory techniques for memory impairments

• Provide cognitive exercises among a host of other therapies

The best outcomes are achieved by a multidisciplinary team of specialists who collaborate to prevent intervention gaps. It is not necessary for all team members to be in the same clinic. A thoughtful and conscientious provider will refer to other specialists who have expertise in addressing PCS and other complicated conditions.

As a patient, you have a choice in who you hire to be your health-care partner. Choose relentless investigators who work hard at finding integrative therapeutic solutions for your condition!

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