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


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Old 05-11-2022, 05:01 PM #1
Michael4 Michael4 is offline
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Default Trauma Triggered Migraine as Explanation for Bumps Causing Neurological Symptoms

After reading BurritoWarrior's post, I began looking into head jolts causing migraines. I was initially very skeptical, believing these events were mini-concussions, but I was quickly convinced as I read literature reviews. The most important paper on the subject I have come across is titled "Trauma-triggered migraine: an explanation for common neurological attacks after mild head injury." This paper begins by listing studies, dating as far back to 1898, where doctors observed patients experiencing neurological symptoms after mild head trauma. The paper discusses laboratory findings, such as how "All EEG recordings made during TTM attacks have been abnormal...." The article firmly states, "That head trauma itself rather than its emotional concomitants elicits TTM attacks is undoubted, for these phenomena do not follow trauma to other parts of the body." The article summarizes, “Minor head trauma sometimes triggers complex temporary disturbances of brain function that are often alarming and can last from hours to days. Occurring particularly in children and adolescents, these attacks contrast sharply with the brief dazed states that typically follow minor head trauma. For two decades now, these attacks have been identified as "migraines" in a number of studies. Yet this identification is not well known to physicians and surgeons who care for head-injured patients and is sometimes not even mentioned in current discussions of these attacks.”

Furthermore, another article titled "Traumatic Migraine Versus Concussion" states, "There are no symptoms that differentiate trauma-triggered migraines from concussions...."

It was quite reassuring to learn that the ability for minor head impacts to cause concussion-like symptoms was accepted in the literature, with hard evidence such as EEG findings backing it up. My neurologist accepted my research and plans to treat the disorder with the traditional migraine protocol.

It is important to note that the first literature review I cited states that prophylactic medication can only treat the headache itself and not the cognitive symptoms, so it would seem wise to avoid head trauma to a reasonable extent.

I am looking into botox treatment as other prophylactic medications such as Topiramate don't seem to be well-tolerated, and the side effects of botox are very minor.

I would like to add that I find tea helps attenuate the TTM attacks, presumably as caffeine is known to reduce migraine symptoms. In one of my previous posts, claiming testosterone therapy "cured me," I overstated the benefit this therapy conferred to me. I noticed that the symptoms greatly reduced, so I prematurely concluded I would eventually be completely cured. Unfortunately the testosterone-blunting effect plateaued. But, the headache blocking effect was significant and exists. The article "Testosterone levels in men with chronic migraine states," "These studies demonstrate that testosterone effectively treats migraine headaches in both men and women and that low testosterone is likely causal and not the result of migraines."

I have also looked into ADHD to explain my cognitive symptoms, separate from a TTM attack. I scored highly on the ADHD diagnosis test, and received an ADHD diagnosis from my psychiatrist. I am unsure if I truly have ADHD, possibly worsened by concussions, or if the cognitive symptoms are from PCS, but regardless, the ADHD medication methylphenidate has been shown to ameliorate PCS symptoms in "Long-term treatment with methylphenidate for fatigue after traumatic brain injury," which my primary care doctor also corroborated. The methylphenidate has been tremendously helpful for almost all of the symptoms I have experienced. From my research, methylphenidate seems to have a very good side effect profile, and most of the stigma against the medication is unwarranted. I have not experienced any side effects except for appetite suppression.

But, there exists evidence that tolerance to ADHD medications builds, despite what anecdotes online say, so it is advisable to take drug holidays. My psychiatrist also recommends drug holidays.

Finally, I have noticed I have a sensitivity to smell called osmophobia, which is very prevalent in migraine populations. Whenever I smell odors such as cooking fumes, motor vehicle exhaust, or cigarette smoke, I get dizzy and experience cognitive symptoms. I was wondering if anyone else experiences this.
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Old 05-13-2022, 12:35 AM #2
Mark in Idaho Mark in Idaho is offline
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You must be avoiding the methyphenidate reports that look at the negative value. The last time I looked, there were more saying ADHD meds value is short term and fraught with negatives for the neurologically stressed.

Are you looking for a drug regimen to use at a maintenance level?
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Old 05-15-2022, 02:56 PM #3
DrewDigital DrewDigital is offline
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If you look at the most severe PCS cases, two factors are usually involved - pharmaceutical drugs such as antidepressants, pain meds, or migraine cocktails, and multiple head hits.

I would advise against the migraine protocol because they usually involve those medications.

You mentioned - "It is important to note that the first literature review I cited states that prophylactic medication can only treat the headache itself and not the cognitive symptoms, so it would seem wise to avoid head trauma to a reasonable extent."

A good way to avoid the minor head bumps is to wear a padded hat to protect the brain while it is recovering. The Ribcap is a good one:
Protective Special Needs Helmets for Adults & Children | Ribcap
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Last edited by DrewDigital; 05-15-2022 at 04:12 PM.
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