Yes, I think it is possible for someone to "pass" those tests and still have a vestibular issue because sometimes those symptoms seem to come and go with specific movements, etc. That's why you want a tilt table test...I think.

I've got a pre-concussion background that includes soft-style martial arts, yoga, climbing, cycling, gymnastics, ballet, etc. My ability to perceive myself in space and navigate that space was top-notch. I could easily walk around the house, or walk a balance beam, with my eyes closed.

Post-concussion I've got some very big vestibular problems. Walking and standing are challenging. Getting back on a bicycle seems suicidal. More than once I've stumbled past small groups of hobos (drinking cheap booze from paper bags) and been greeted with "Hey man, are you alright? You need any help, man?" I'm not proud, but am I'm not ashamed to admit it.

Certain sounds make me dizzy. Loud noises make me jump.

I had a few sessions with a neuro-vestibular-physiotherapist, and she told me that if it wasn't for my background with physical movement, I probably wouldn't have been able to stand up: that's how bad my balance was (still is?). At the last session she mentioned that it made no sense to her that in some ways I was improving, but in other ways I wasn't. If anyone can comment on that...

Anyway, one of the things I've learned to do pre-concussion is allow myself to use visual and tactile feedback to control my balance. Post-concussion, it's the only way I can stand up. 9+ months later and still, if something moves through my field of vision it will almost knock me over.

I can stand in a doctors office, visually focus on a point, and walk in a dead-straight line for a a meter or two. But if you put me on a sidewalk with noise, cars, buses, people, etc then I stumble like a drunk. In laboratory conditions my balance is fine, according to that test. Everyone is different, but even for people without a background in physical movement the "laboratory conditions" of a doctors office, combined with a very brief test, could probably make things look better than they really are.

notcrazy,

If these are your 'you wont believe this' symptoms, they are uncommon but not unheard of. I have trouble standing with my eyes closed. Never did before. The balance in a chaotic environment is due to over-attending. Your brain has too much information to process. This, again, is not unheard of.

You likely have a problem with how your brain is gating information between different areas. Instead of a constant flow of balance information, it allows sound and visual to 'cut in line' and disrupt the flow of balance information. You brain's bandwidth of information processing has been seriously narrowed, if you understand some computer speak.

Some intense vestibular therapy may be able to strengthen the vestibular neural pathways but it is a slow process. Starting in a sterile clinical environment and then add external stimuli. As the brain relearns how to block the distractions and stay focused on the vestibular information, hopefully, you will improve.

You might want to check out http://vision-audio.com/ease_overview.html to see if their system of auditory desensitization will help.

You mentioned martial arts. Have you done sparing where you get hit in the head, even if while wearing head gear?
This can set your brain up to be overly sensitive to the knock out blow you took. It is knwo by some that sub-concussive impact can cause brain injuries, especially when there are many with concentrations of these sub-concussive impacts during practice sessions.

Studies show that the average football (American) players suffer 600 to 900 sub-concussive impacts during a season. They may not suffer any concussion symptoms from any individual impact but the accumulation is showing to be dangerous. Helmets do not decrease these subconcussive impacts but in fact, make them more likely to happen. The head gear creates a false sense of security.

Your use of visual and tactile information to balance may have been in response to losing some of the basic balance skills from martial arts head impacts. You were multi-tasking to balance. Now, you have lost the ability to multi-task, at least temporarily. This is very common with concussion.

Hope we can help.

My best to you.

Just soft-style forms (mostly tai-chi), and no full-contact or full-force sparring. I've had knocks in the head (not martial arts) but no more than a 20-30 seconds LOC (that was once; I was about 10 years old). The most recent hit (before the BIG one) was about 10 years ago and resulted in 1-2 seconds LOC. I can probably count on one hand, maybe two, how many times I've had any significant knocks to my head.

Edit: Based on my understanding of physics, I'm lucky to be alive after the BIG one. I don't think sensitization was a factor. Based on what I deciphered from the bruising and cuts (a: I know my own body pretty well and b: I used to be an emergency medical technician) it was a solid hit against a tile/concrete floor.

notcrqazy,

The 30 sec LOC at 10 yo was a very significant impact. Even the 1-2 sec LOC is significant.

LOC elevates any concussion to a serious level. Your comment about any 'significant knocks to the head' is interesting. Your brain does not need a significant knock to the head to be concussed based on your history.

Have you ever had a light bump to the head where you had a metallic taste (like chewing aluminum foil) in your mouth or you say spots for a few seconds?

Studies show the brain can tolerate some severe hits without any immediate concussion symptoms. Impact forces from 60 to 170 G's were recorded. Many were not even obvious when video tape was reviewed. The brain's tolerance is variable from one person to the next. It is known that immediate symptoms or lack thereof do not necessarily predict later symptoms.

For you, the important issue is your current symptoms. Concussion is not treated as a cluster of symptoms. Rather, the individual symptoms are treated. By treated, many times this just means developing acceptance of the symptoms and learning to work around or with the symptoms.

Learning to avoid certain environments is imperative. Learning to minimize all symptoms is valuable because studies show that healing is most likely during symptoms free periods.

You definitely sound like a Multiple Impact Syndrome candidate. You may have reached your limit for recovery due to available reserve brain capacity. Your only opportunity for recovery may be learning to minimize some symptoms and learning to live with the others. Work-arounds and other accommodations can enable you to return to much of your previous life.

At this point, you will need to get to know your 'new' body/brain. Your prior physical capabilities have little bearing on your current condition.

List your most disturbing symptoms so we can offer suggestions for work-arounds and other accommodations.

My best to you.

I really don't know how long I was out, that first time. Long enough for a small crowd to gather, not long enough for anyone to do anything. Based on the circumstances, my guess would be 15-30 seconds. I spent a few days laying in bed, eating soup, and then I was back to normal.

The one about ten years ago, I went over the bars on a bicycle. I woke up laying on my back, in the middle of the street, but the bicycle was still in the air and I had enough sense and time to kick it away from me; otherwise it would have landed on top of me. I couldn't have been out for long but there was definitely a sense of lost time and "where am I? How did I get here?" feeling.

I think I may have had another brief(?) LOC falling out of a tree when I was a kid.

The first time and the last time where the only ones that left me with any fatigue, dizziness, headaches or any other symptoms I would typically associate with a concussion.

Oh man... There was also the time I fell asleep at the wheel and split a utility pole with my VW rabbit. I was young and I didn't realize that driving while tired is just as bad as driving while drunk. That may have rattled my brain...?

Well, the most recent knock was significant by any account.

Almost 20 years ago I got into a fight at school. I let the other guy get the first punch before I kicked his @$$ (The rules of engagement on school property encouraged me to not throw the first punch). His first shot was pretty good; His class-ring against my left eye. I saw stars and had a helluva lump, but otherwise no damage that I noticed. Several people commented that they heard the sound of how hard I got hit and they were impressed that it didn't fall down from it. That was the last time anyone at school picked on me

I should mention that the neurologist I was sent to, who I have no respect for, made it clear that these types of prior incidents have no bearing on my current "alleged" symptoms.

I don't recall any metallic tastes. After getting punched in the eye I'd say I saw stars. Haha... then I got my bearings, and I just remembered the look on the other kid's face... He looked terrified that I was still standing.

If that's the case, I also have to convince ACC.

* If I take it easy, I'm sleeping about 50% of the time - 12 hours out of 24
* Memory, focus, concentration, reading comprehension are all crap. This puts a damper on my career with computer stuff
* Balance is a huge problem. Walking is a challenge
* Headaches. For both practical and ideological reasons I don't do painkillers

not crazy,

Not attempting to relive your head aches could be making things worse. You need to get some relief. I just use Tylenol and aspirin. I do not use any of the stronger meds. If you state your refusal to use meds to a doctor, that can go against you. keep these comments to yourself.

You definitely qualify as Multiple Concussion Syndrome. Do some online research and take a few peer reviewed article to the next doctor you see.

You found a doc who does not believe in persistent PCS. That is not uncommon.

Write down your history of concussion/head impacts with your immediate symptoms and recover timelines. You may or may not have lost consciousness. You may just have experienced PTA, Post Traumatic Amnesia. It is more common that LOC. You can experience PTA without LOC. Some docs do not believe a concussion happens unless you have LOC.

LOC does not make much difference anyway. You treat the symptoms, not the event. I have not had LOC since 1965 at 10 years old. But my minor concussions since then have devastated me. My personality has changed. My IQ is still very high but my memory and cognitive skills are very low.

You need a neuro-psychological assessment. It is the long evaluation. Can be 2 hours to two days, depending on the battery of tests used.

Limit your time on the computer. Take frequent breaks. Watch for mental fatigue and get up and walk away as soon as you notice any fatigue.

I find myself rereading the same line or staring blankly for a moment. This is a sure sign to stop and do something else.

My memory is so bad that I have learned to use the computer screen as short term memory. I can reread what I have typed to keep track of my thoughts.

Did you read the nutrition posts? This is very valuable for a healing brain.

btw, I use frequent paragraph spaces so that i can follow the text from line to line. More than 5 or 6 lines and my eyes can not follow to the start of the next line. Work at learning these kind of skills and accommodations. I depend on spell checker. Firefox has spellchecker that works within online forms like this post.

Do not try to be proud. Humble yourself and let your life happen. You can always get stronger later, but fighting your symptoms only makes them worse.

You sound like you are in your 40's. This is a common time for past concussions to catch up with you. The brain starts deteriorating and the past damage starts to rise to the top. Welcome to middle age.

I'll try to send you the TBI Survival Guide doc file. It is very good. So is the file at http://www.lapublishing.com/blog/wp-...al_English.pdf

My best to you.