VIRGINIA COMMONWEALTH UNIVERSITY

NATIONAL RESOURCE CENTER
FOR TRAUMATIC BRAIN INJURY

Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.

Pat #25

DEAR PAT: I was injured in an automobile accident almost 20 years ago. Way back then, little attention was paid to my head injury and the orthopedic surgeon was mostly interested in fixing my broken bones. About 10 years ago, I began noticing head-injury related symptoms as they became more annoying and painful with age. I’ve been to an ENT [Ear, Nose and Throat doctor] for tinnitus [ringing in ears] (she gave me sinus medication), a neurosurgeon for advice about tingling and crawling sensations in my left side (he said that removing cervical spine bone spurs would not solve the problem), an orthopedic surgeon for arthroscopy on my left knee (this helped a little, but my leg still hurts), a neuropsychologist (she has identified logical and reasoning issues that seem related to frontal lobe injury), and a psychologist (he thinks I have a personality disorder). In the last several months, I’ve seen a neurologist who thought I had MS [multiple sclerosis], but now that he has decided that I don’t have MS, he doesn’t know what’s wrong with me.

Taking matters into my own hands, I’ve gone back to the hospital that treated me after my accident to retrieve old records. After much back and forth, I was able to sweet-talk someone into finding the microfilm. I read through the records and discovered that I had an open wound in the frontal area and that x-rays showed a soft tissue injury in the parietal region. Could the parietal region injury be to blame for the pain in my left side, which includes inability to discriminate temperature and pressure, surface tingling and burning, zapping sensations that feel like weak electrical shocks especially in my foot and hand, maddening tinnitus and increasing weakness in my left arm and leg?

PAT’S RESPONSE: I doubt that 007 could have done much better retrieving the microfilm from your medical records! All joking aside, active participation in your medical care is vital for survivors of brain injury. Brain injuries generally result in complex problems requiring help from a number of professionals such as physiatrists (doctors of physical medicine and rehabilitation) and other “neuro” specialists (neurosurgeons, neuropsychiatrists, and neuropsychologists). As you have experienced first-hand, even medical professionals may have difficulty knowing exactly what is going wrong with an individual coming to them for help.

An important first-step is seeking out advice about symptoms and recovery from a treatment professional with expertise in helping people with brain injury. Your local chapter of the Brain Injury Association of America (Phone: 800-444-6443 or E-mail: familyhelpline@biausa.org) can provide you with a list of rehabilitation specialists in your area. Offering education, support, and referral services for individuals with brain injury and their family members are primary functions of Brain Injury Associations around the country.

People with brain injury sometimes feel strange sensations on their skin or notice other physical changes. Paresthesia is a term describing abnormal skin sensations such as burning, prickling, itching, or tingling usually felt in the hands, arms, legs, or feet with no apparent physical cause. Injury to the brain’s parietal lobe or sensory pathways may result in paresthesia. Other medical conditions such as MS, stroke, diabetes, and rheumatoid arthritis have also been known to cause paresthesia according to the National Institute of Neurological Disorders and Stroke (NINDS). For more information about neurological and medical conditions associated with paresthesia, you may contact NINDS directly (301-496-5924) or visit their web site (www.ninds.nih.gov).

The appropriate treatment for paresthesia depends on accurate diagnosis of the underlying medical cause. Doctors base their diagnosis on a number of factors like a patient’s complete medical history, physical examination, and laboratory tests. A comprehensive evaluation by a physician with experience treating persons with head injury may be beneficial. You may also benefit from speaking with other survivors of brain injury and their families about ways they have found relief from brain injury-related symptoms. The Brain Injury Association of American is an excellent source of information about support groups in your area. If you have internet access, their web site is www.biausa.org. You will also find links to local Brain Injury Association chapters through the site.

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