The stress of neurologist reports. sorry it's a bit long
 

Last week I received a neurologist report (10 weeks after I had the assessment done!). Prior to receiving it I promised myself I was not going to get stressed about it, but unfortunately the stress levels have increased somewhat. It is only a 2 1/2 page report and it is so inaccurate, I had to keep checking it was actually about me. I don't understand all of it and have to put my questions in writing (it's all a bit of a process!). Interestingly the neurologist did not think it was important to report that I have suffered five previous concussions, but he thought it was important to report I wear spectacles (which I do not) and have regular dental care. I am now in the process of writing what changes I would like made in the report - I have written 5 pages and the report was only 2 1/2 pages!


A sentence I found interesting in the report was as follows:
'Whilst some clinicians might describe this as post-concussion syndrome, this does not adequately serve our patients for there is no clinical criteria, no diagnostic tests and no treatment pathway nor prognosis factors, thus I do not believe Sharon has post-concussion syndrome. I suspect she has functional and dissociate neurological symptoms that account for her presentation.'


And another sentence:
'It may be helpful to set reasonable expectations and discuss the aetiology of her complaint, which I would summarise as a constitutional syndrome with components of headache and anxiety, but together these do not explain all of her symptoms.'


Fortunately I no longer suffer headaches regularly - only when I push myself and do not take rests when I should, and the anxiety I experience is only mild and related to the uncertainty of when I can return to full time employment.


So what diagnosis is it, or do they mean the same thing? Can anyone explain in plain language what functional and dissociate neurological syndrome (which the neurologist also refers to) and constitutional syndrome are?


I have a neuropsychologist report (from January 2014) stating I do have symptoms consistent with PCS and my cognitive abilities are significantly impaired by fatigue. I know I have PCS, and like so many other people with PCS seem to have to battle those people who think if we push ourselves just a little bit harder we can do a little bit more. I am working 3 hours 3 days a week. Even my GP thinks that I should significantly increase my hours because my system is just out of practice of going to work and needs to 'recondition' itself to working more hours. GP also thinks I am just lacking a bit in confidence so should just throw myself back into work. This is frustrating - if I try to work more my head feels like it is about to explode, and it takes me a few days to recover. I want to be fully functioning and working full-time (and not needing rests and sleep during the day) but my brain is not up to it at the moment - I believe I will get there and am determined to.


I think fatigue is the only symptom that is currently an issue for me-(but which impacts on my attention, memory, balance, emotions, etc...). I am also good at denying my symptoms!


I am new to this forum, sorry about the rambling - just needed to get stuff out of my system.


Questions: Can anyone explain in plain language what functional and dissociative neurological syndrome is?

Anyone know of any neurologists in New Zealand (preferably North Island) who has a good understanding of concussion?

PS - I initially posted this at the end of someone else's post and have just realised how to do my own post!

Cheers,
Shazza

Cheers,
Shazza:

I would contact one of these

List of NZ Brain and Head Injury Associations

and ask for advice.

Any Rugby Association over there would have guidelines too.
If all else fails, ask them.

Thanks heaps Lara.

Most appreciated.

This report is very interesting and odd.

"Whilst some clinicians might describe this as post-concussion syndrome, this does not adequately serve our patients for there is no clinical criteria, no diagnostic tests and no treatment pathway nor prognosis factors, thus I do not believe Sharon has post-concussion syndrome. I suspect she has functional and dissociate neurological symptoms that account for her presentation."

It sounds like he is saying that since there is no set of symptoms and other criteria for PCS, you must not have PCS. This is like someone who is color blind and can not see blue saying the sky can't be blue just because he can't see the blue.

fyi, Constitutional symptoms refers to a group of symptoms that can affect many different systems of the body. I think this is what he means by constitutional syndrome.

Check out http://www.neurosymptoms.org/#/disso...oms/4533053148 for the other comments.

Many neuros take a position that if they can not image it or otherwise define the set of symptoms nor have a way to treat them, they must not exist. A sort of "I can treat everything. If I can't treat it, it does not exist."

What you are experiencing with this neuro is not uncommon. It is distressing, though.

My best to you.

Neurologists
 

I had the same vague report from the first neurologist I saw.
The same as you I avoided all stress before the examination so that I could verbally describe my symptoms.

The quack never asked me any questions and just gave me various balance and movement tests. His conclusion was the same as yours, psychological a disorder of the mind and not physiological a disorder of the brain.
Unfortunately these dinosaurs still practise causing turmoil and harm with their ignorance.

When you do get examined by a qualified neuro-psychologist or neuro-psychitrist you will overjoyed that there are a few whom truly understand what a brain injury incurs, and receive the appropriate treatment.

I agree with Edcase. I was lucky enough to get a good neuropsych. A very good one. He realizes what I have is a brain injury through trauma, and not a psychological blame. My work didnt like the report because it shows impairement, but man was it nice to get answers.