Guest UVAPAC Posted August 18, 2017 Share Posted August 18, 2017 I am looking for opinions from those who have worked in the field of Neurology: I have seen an enormous rise in patients with "post-concussive syndrome." All kinds of mechanisms of injury... MVA, punched, fell, hit head on fireplace, walked into steal beam, etc. I have read as much literature as I can, and seemingly the United States of America is just about the only place the post-concussion syndrome exists. UpToDate goes as far as suggesting that a suspected reason is monetary gain / litigation against others. 1) Do you feel post concussive syndrome is real? 2) A patient has negative CT of the brain, negative MRI of the brain, but continues to have symptoms for months after injury occurred... is there any good explanation for this? 3) With these patients... we have tried TCA's for headaches, SSRIs for apathy/depression, neuropsych testing, psychiatry consults, with an extremely low rate of success. Any other suggestions as to how to treat these patients? 4) As far as returning to work and activities, is there any timeframe you suggest? I have had patients 3-4 months after a blow to the head with a completely negative workup claiming photosensitivity, apathy, fatigue, headaches, nausea, tinnitus, etc. 5) For the record, after managing these patients in our office for 2 weeks I have began to refer to Neurology simply for the fact I have lost confidence/faith that any of these patients will "get better." Therefore I defer to a specialist to determine when they are fit to return to work/school/etc. Link to comment Share on other sites More sharing options...
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