Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 04-15-2013, 11:22 AM #1
Mokey Mokey is offline
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Shocked Auditory brainstem, neuro-audiology and auditory processing

Hi all!

I am feeling as if I am not able to get beyond a certain plateau that I seemed to have reached. I have had a horrible three weeks or so, and even on those days when I feel more functional, it is AT HOME, in a QUIET space! I am still unable to function in noisy environments, or when there are multiple sources of noise.

In trying to understand this and find new therapies which go beyond the advice of increasing exposure to noise, I have come across some interesting articles and research on:

- neuro-audiology
- auditory brainstem testing and damage from MTBI
- auditory processing disorders as a result of MTBI
- dichotic interaural intensity difference training (DIID)
etc!

I had a hearing test which showed my hearing was great (I have hyperacusis! of course it is 'great'!!!!

But no other tests for this problem.

Before I post some interesting links, I wanted to see if anyone else has had assessment, treating, therapies, etc. for the sound assaults that they are dealing with on a daily basis. Tinnitus and hyperacusis. etc.

A lot of the studies I have read this morning discuss how the traditional neuro-psych testing does not pick up on this problem...first reason is that the testing is done in a quiet environment!

Thanks! I think I am on to something for myself, at least. Looking forward to hearing other suggestions.

hope everyone is having a good (and quiet day. Sigh.

If anyone wants links to these discussions, send me a message or post here.
M
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.

Last edited by Mokey; 04-15-2013 at 11:36 AM. Reason: Typo
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Old 04-15-2013, 01:45 PM #2
berkeleybrain berkeleybrain is offline
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Mokey, I'd love a copy of the links.

I'm going to the ENT tomorrow to find out more about my own situation regarding dizziness, nausea, tinnititus, hyperacusis, etc. My question is do you all have suggestions on _what_to ask the ENT about?

I've lost 35 pounds since the accident last July 2012. small silver lining, but I'm not in control since I often vomit if I get to nauseous. I often feel like I'm on a ship, and on the right side is like a mirror fun house in terms of feeling. Visually it's okay; it just feels funny.

There is some visual-vestibular connection, but I'm not sure what. I am also on prism glasses and undergoing vision therapy for convergence insufficiency. The optometrist thinks I have another 9-12 months to go.

Any advice would be greatly appreciated! Thanks to you all-this forum has been a life saver.
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The event: Rear ended on freeway with son when I was at a stop in stop and go traffic July 2012. Lost consciousness.

Post-event: Diagnosed with post-concussion syndrome, ptsd, whiplash, peripheral and central vestibular dysfunction and convergence insufficiency. MRI/CT scans fine.

Symptoms: daily headaches, dizziness/vertigo, nausea, cognitive fog, light/noise sensitivities, anxiety/irritability, fatigued, convergence insufficiency, tinnitus and numbness in arms/legs.

Therapies: Now topamax 50mg daily; Propanolol and Tramadol when migraine. Off nortryptiline and trazodone. Accupuncture. Vitamin regime. Prism glasses/vision therapy. Vestibular therapy 3month. Gluten free diet. Dairy free diet. On sick leave from teaching until Sept. 2014.
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Old 04-15-2013, 01:57 PM #3
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If he can see if your vestibular is off in your inner ear.I had also lost a lot of weight during the time I waited for a diagnosis and was vomiting EVERY DAY.Hope you get some input from the ENT.
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What Happened: In 2011 I was in a MVA
.


Symptoms: Physical: I am always cold in any season!!I cannot tolerate anything pressure on my head(sun glasses,hats)longer then a hour,Lock jaw/Displaced TMJ, Dropsey, Hands go numb, Arms go numb, back of head numb (when asleep),Muscle spasms in face & upper body,migraines, concentration headaches, dizziness, nausea, neck and back trauma (from accident), tinnitus, extreme light sensitivity, noise sensitivity, EXTREME fatigue, impaired vestibular system, balance off, Pupils NEVER equal, disrupted sleep cycles,speech problems.

Cognitive: Cognitive Behavior, Brain fog, impulsivity, speech problems, word finding problems, slowed processing speeds, impaired visual memory, impaired complex attention

Emotional: Unable to handle stress or overstimulation without getting extremely irritable or angry, easily overstimulated, MAJOR depression, major anxiety, Panic attacks

Treatment so far: Treatment for PCS,PTSD,Depression & panic,Vestibular therapy, Physical therapy, Vitamin Schedule,Walking,No Dairy, No eggs, No caffeine, No artificial coloring, Sleep with 2 pillows, Very little sugars consumed, Eat healthy,No alcohol, Medications, limit stress and overstimulation.

~*~Learn to treasure yourself and your Divinity. Be willing to accept yourself completely. Be yourself, be graceful, be kind, be wild, be weird ... be true to yourself~*~
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Old 04-15-2013, 02:43 PM #4
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Terrible that you feel so bad! Nausea is horrible, on top of everything else. Will post some interesting links after I get my kids from school.
M
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.

Last edited by Mokey; 04-15-2013 at 06:15 PM.
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Old 04-15-2013, 06:30 PM #5
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Crazy

As promised:

1)
Here is an interesting case study about a woman who had pcs after falling off a horse. Many of us have similar issues. Some treatment solutions near the end of the article.

http://citeseerx.ist.psu.edu/viewdoc...=rep1&type=pdf

2)From the Audiologists's association website:

http://www.asha.org/publications/lea...91124/CAPD.htm

3) a great blog post on NOISE

http://www.fightingpcs.com/2013/02/n...further-study/

4) a powerpoint presentation on auditory processing problems after tbi )in military but they are just like us!

http://www.afaslp.org/AVAA%20conferences/Gallun2008.pdf

5) a powerpoint from an academic conference on brain rehab...explains a lot.

http://www.scripps.org/assets/docume...aud_fabian.pdf

From this last presentation...the slide which talks about the symptoms of central auditory processing disorder:

'Symptoms of Auditory Processing Disorders
Common symptoms of CAPD are:
• inordinate difficulty hearing in noisy or reverberant
environments;
• difficulty following conversation on the phone
• difficulty following multi‐step directions
• difficulty following long conversations
• difficulty taking notes
• difficulty with social situations—difficulty “reading”
others / pragmatic communication issues
• difficulty with spelling, reading and writing
• lack of music appreciation
• difficulty directing, sustaining, or dividing attention '



That's all for now. Hope it helps. I have called the U Conn. clinic and hope to speak with someone tomorrow to get more information about testing and therapies.

Leave no stone unturned!!!!
M
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 04-15-2013, 06:43 PM #6
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I was diagnosed with an auditory processing disorder with an Auditory Evoked Potential test (AEP) with qEEG processing. My doctor looked at the results and said, "You hear everything. How do you handle that ?" My wife responded, " He doesn't. "

It has been 12 years and I am still dealing with these issues. I have learned to avoid most environments where I will have a problem. I also use foam ear plugs in restaurants and other noisy places. I sit at the back or perimeter of a room where there will be less noticeable echoes.

I can hear echoes that nobody else hears.

My AEP was repeated a few months later to validate the results. My doctor was so impressed by the level of lack of auditory filtering that he repeated the test a few months later. I had it repeated years latter with the same results.

I may have a little better organic tolerance for sound but believe most of my tolerance is due to work-arounds.
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Old 04-15-2013, 06:49 PM #7
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Mokey, I think I mentioned this before but I was in the same situation, pretty much ok at home but in noisy environments or confusion/busy places I was having sounds sensitivities, dizziness, brain confusion/fog, etc. Ever since starting Effexor, for these anxiety symptoms, they have been significantly improved! Even my light sensitivity.

I believe Mouse has had the same results. If you are that desperate, perhaps it would help to try this solution. You could see almost miraculous results. I was shocked what was helped by this medication. It allows the rest of the brain issues to start to heal better once the anxiety responses are controlled.

These are PHYSICAL anxiety responses, not emotional and you cannot control them on your own. If you don't want to try Effexor, there are other options.

For the others in this thread, I had no luck at all with my ENT but your situation may be different. There is supposedly only one type of dizziness that they can help with and mine was not that type. (if you roll over in bed and get dizzy and nauseous then an ENT may be able to help you)

Just some thoughts. Good luck to you.

CC
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I'm a 39 year old, female, accountant. On July 2, 2012 I crashed my bike at the end of a 65KM road ride. I was fine that day but woke up the next morning to my current world.

Ongoing symptoms include: dizziness, blurred vision, light and noise sensitivities, cognitive problems, uncontrollable emotions/depression/anxiety, headaches (but they're getting better), mental and physical fatigue, difficulty communicating and sleep disturbances.

Currently seeing a fabulous Neuro Psychologist and vestibular physiotherapist and hoping to soon see a neuro ophthalmologist. I am currently doing 20 minute stationary bike rides daily, 20 minutes of meditating, 15 minutes of Lumosity and lots of resting. I have not been able to work or drive since the accident.

The things that have helped me the most since the accident are vestibular therapy, gel eye drops (for blurred vision, sensitivity and dryness), amitriptyline (10mg), and meditating. I am finally starting to see some slight improvements and am hopeful!

My brain WANTS to heal itself... I just have to let it and stop trying to get better!
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Old 04-15-2013, 06:54 PM #8
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Thanks, Cycle crash! I am seriously contemplating digging into the cymbalta samples a doctor gave me last year! But my good doctor left to do other things and I have no brain injury doctor right now, so it is probably not a smart idea until I talk with someone. The new GP has no interest in this injury because it takes more than a seven minute visit to solve problems.
As soon as I find a doctor in this area, i will raise this as a possible therapy (drugs!).

I had a HORRIBLE experience with a new potential doctor on Friday....so difficult to find a good one!

Thanks!
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.

Last edited by Mokey; 04-15-2013 at 06:59 PM. Reason: Typo
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Old 04-15-2013, 06:57 PM #9
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Thanks Mark. I hear everything too....it is horrible! I have tried to avoid noisy places but it is a huge impediment to me going back to teaching which I still want to do, and to living a better life with my young kids.

If you have other suggestions for testing for this condition, i and others would appreciate it.
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 04-15-2013, 07:14 PM #10
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Mokey,

I recommend you stay away from the Cymbalta samples until you have a doctor who is in support of you taking it. It will take a few weeks to see a difference anyway.

If you are going to self medicate, try a capsule of L-Tryptophan twice a day. It will show a change that day.

Have you ever had your B-12, D3, and folate tested ? You might be one of those who does not process (methylate, I think) B-12 and folic acid properly.

mrsD has quite a write-up in the Vitamins sticky.
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