My daughter's psychologist and neurologist went back and forth about prescribing ritalin. They decided not to because ritalin can cause headaches and that was a huge problem at the time. If that isn't an issue for you it might be worth looking into.

I've always wondered if stimulants would be helpful in with PCS. Many of the symptoms overlap with ADD. I have often found myself thinking my daughter has concussion induced ADD.

But then you wonder - if the injuried brain needs to rest and little to now stimulation - wouldn't the use of stimulants be counter productive? When do you say - you've "rested" enough and have to move on and try things other options?

My daughter did have qEEG. The results were interesting. It came back more as if she had ADD rather than a head injury. I'd have to say the bulk of the issues I have seen post injury weren't present prior to her head injury - though ADD does run in our family.

That is a very good question. Over the years I've wondered if my daughter had a mild form of ADD as she goes from one thing to the next very quickly. For example, she always seems to be the last one to get a joke. Not because she didn't understand it, but because she had jumped past the punch line and started thinking about other implications. She could always pull her thoughts together enough to pay attention in school, which has been a problem since her injury.

I'm also interested in your comment about "rest and little to no stimulation." Neither our GP nor our neuro suggested this. They both said, "let her do whatever she feels like as long as it is not going to result in another impact." So for 7 months that is what we have done. I pray we haven't slowed her recovery down by not further restricting stimulation. And you are right...when is it enough? When do you quit telling them to turn down the stereo or reduce screen time?

From my understanding, any activities that require mental recuperation can be counter productive. There is a need to try to minimize such activities and learn to understand the tolerance threshold.

Recognizing where this threshold is takes serious introspection. Young people tend to want to just forge on ahead until they finally crash. The culture of feeling like they need to be constantly stimulated makes this a difficult process.

nancys,

How was your daughter's qEEG analyzed?
Some qEEG therapists do not use an analysis database that has a strong brain injury component. ADD/ADHD is often the primary focus of the therapists since it is the most treatable with volitional neuro-feedback.

The NeuroGuide database includes mTBI discriminant factors. http://www.appliedneuroscience.com/

Mark,
Sorry it took so long to get back to you.
Right now I don't know why they call ritalin a stimulant. I have been dragging. I'm only on a half of a Mg pill at AM and PM, but I have been feeling rather sloooow.
I'm supposed to go up to Mg 2x a day after a week. I think maybe I'm too much of a light weight to handle that.

I do take vitamins. I use sub lingual b-12, a multi-vitamin, biotin, fish oil, melatonin, grape seed, and ginko. My internist laughs at me and says that they are just taking my money.

At this point I'm not worried about the ritalin over stimulating me. I'm worried that I will not get over this doped feeling.

You are way behind the curve with your vitamin intake. You neuro is way off the curve.

What times do you take these supplements and what dosages? A multi is a start but a poor start.

The results were sent to Dr. Walker in Texas for analysis and run through a database. The report came back negative for a head injury. He didn't implicitly state she had ADD, but in looking at the recommended a series of protocols for our neurofeedback guy to target, it implied ADD. Many of the areas were executive functioning areas that significantly decreased as a result of the injury.

What dosage are you one? It could just be too high. It could also not be the right stimulant for you. There are lots of different options out there and not everyone reacts the same even to drugs that are in the same class. Formulations and release mechanisms really have an effect. If ritalin doesn't work, the adderall family is also another option. (My youngest has ADHD and I have lots of experience with different medications...)

In the beginning recovery stage - we were told no stimulation - no screens of any kid (tv, computer, texting, etc). We adhered to that for a while, but as she did get better, we did allow screens but in a limited in time. Check out the following news release:

http://www.childrensnational.org/pre...nesJune09.aspx

I did also read that some screen time is ok. The mindless tv is relaxing to the brain. Watching funny shows is also good for the mood. Now, as long as it doesn't increase symptoms, I don't have a strict limit other than she needs to get off a couple of hours before bed.

Thanks for that link. Wish I would have seen it a long time ago. We imposed strict resting after school and weekends and limited screen time to a certain extent. Her socializing was basically limited to friends who came by our house, but she was still going to school all day. After we saw neuro and pscychologist at 3 months they suggested we forget about grades for awhile but never suggested she stop going to school.

I feel guilty...we definately let her do too much at the beginning. We probably slowed her healing down. But at 7 months we are still seeing lots of improvement. And her neuro keeps saying she is way ahead of the curve for this type of injury, so I don't know.

There has to be a balance somewhere between restricting activities and maintaining some sense of self. I'm afraid too much restriction would have brought on depression.

The question, in my mind, is time. If you impose these kinds of restrictions for, say, one month, and then gradually add activities, then will you be more likely to avoid a prolonged post concussion syndrome? And if you can compare nerve regeneration to how babies develop those little brain pathways, then rescricting activities for too long would actually be counter productive. Don't brains need some stimulation to regenerate and find new ways to accomplish tasks? Isn't that what rehabilitation is all about?

Ugh....gotta love that parental guilt!