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Possible Acquired Brain Injury contributing to my f**ked situation


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Hey guys.

 

I've just gotten into quite a panic after considering an incident I had earlier this year. I've been primarily convinced that my issues are related to HPPD (Hallucinogen Persisting Perception Disorder), though this incident has always been on my mind to some extent I suppose. I suffered from acute hyponatraemia at a festival I went to in January: it was incredibly hot, so I was drinking a lot of water (and only water, I was 100% sober the whole time). When I got quite a bad headache, of course I've been told all my life that water's the best solution, so I kept on drinking :S. After jumping around for a bit at a concert, I left and had a tonic-clonic seizure, accompanied by falling over and hitting my head. The next 12 or so hours are missing from memory save what I've been told and blurry pieces here and there. A couple found me and took me to the paramedics, I can recall having very slurred speech and laboured comprehension interacting with them. They didn't really stick around to describe what had happened very thoroughly which is unfortunate. Apparently I was very dazed and out of it. I woke up in the ER, while peeing for a drug test managed to drop the bottle of piss all over the floor before falling asleep again, so I guess that's an indicator of how gone I was at the time. I'm really not sure just how adequate the initial treatment was because they'd assumed it was all because I'd taken drugs (I hadn't) and were trying to "flush anything out" before treating whatever else. They tested my vision and I had a blindspot in the left field where I couldn't see the torch they were holding. This lead to me being kept in the hospital over the weekend (not a fun time). When I got out, people were telling me for a couple of weeks that I still didn't seem completely with it.

 

What's followed has been a year of hell, of course, but I don't know what role that episode has played.

 

Of course, at the time I was already experiencing pretty unpleasant HPPD (hallucinogen persisting perception disorder). I really can't remember too well how different life was before and after the incident, save that it was really shitty all around.

 

I had an MRI and EEG at the time which weren't remarkable save for a slight white spot in the upper-right (really not sure exactly where and don't have the scans on me at the moment) "consistent with having bumped my head" which I was assured was mild and would recover quickly. I'm aware though that a lot of brain damage just can't be picked up by typical scans and now I'm fretting that I'm not only looking at HPPD but also an undetectable ABI.

 

I'm just wondering if anyone knows what I'd best do in this scenario? I've read that there are more sensitive scans that can detect the "shearing of brain cells" from traumatic brain injuries that would normally go undetected but still cause a notable blow to cognition. I read something about a qEEG possible also being of value. I'm not sure if there's anywhere I might be able to receive any such specialised scans in Australia, or indeed whether I might have already undergone the best analysis I have access to. The scans I've received were at the Australian Brain and Mind Research Insitute which has a sizeable neurology sector but I'm not sure of just what scans they might've run given my main claim at the time was drug-related impaired cognition... They did know about the hyponatraemiac seizure episode, of course, so perhaps they ran tests with that in mind...

 

I don't know whether it's appropriate to email the research professor I've been seeing about this, I don't really want to bother him with a spur-of-the-moment hypochondriac rambling... He's clearly a very busy, highly qualified guy who's gracious enough to consult patients when he can.

 

Fuck. Being in a situation like this really does foster rampant hypochondria. Fuck all this ambiguity about what's caused what... I'm just quite panicked right now. Eugh

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Hmm, well what issues are you currently dealing with that you think might be related to your head injury? It would be good to write down all these issues before you contact a doctor, just so that you are prepared. I don't see a problem with contacting a doctor if you have issues that are interfering with your daily life. Maybe start by contacting your GP and sharing the list of symptoms with them?

 

I think it's natural to be afraid of serious injury when we hit our heads. It's pretty scary to injure your head. It's also pretty scary to lose hours and have the symptoms you described. So, don't beat yourself up for being worried. 

 

I'm sorry you've had a year of hell. I experience visual hallucinations from my schizoaffective disorder that are similar in nature to what I've read about HPPD disturbances (however I've never used substances). I know how annoying and crappy visual disturbances are. So, I just wanna say I sympathize. 

Edited by Parapluie
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The fumbling, ante and retrograde amnesia and feeling out of it and confused, even for many days, are pretty standard with a tonic-clonic, so that shouldn't worry you. So are slurred speech and difficulty interacting. Your brain just underwent a massive electrical shit-storm, it can take quite a while for things to clear up.

 

There is nothing an ER could do to treat a tonic-clonic, whatever the underlying cause, that could create any long term damage, flushing you out for imaginary drugs or no. They basically want to make sure you haven't hurt yourself, that the underlying cause is addressed (which was the over-hydration), and to make sure your oxygen levels are okay. People often stop breathing during seizures, so they need to make sure you have an 85+ blood oxygen level before they will let you go. They actually prefer it to be higher, but 85% is acceptable.

 

You probably had a big wallop of lorezepam in you, as well, which could fuck you up. It is pretty standard for EMTs to pump seizure patients full of lorezepam.

 

I know that TBIs can cause holes in your visual field, but you should be aware that the blind spot in your field of vision might already have been there. Lots of people have "holes" in their field of vision, which their brain kind of "digitally" paints in. The upper right mark on your MRI is not anywhere near your occipital lobe, so it is unlikely you suffered damage to your vision given the location of the bump. I'm not saying don't bring it up with a neurologist or opthamologist (sp?), make sure that you do. But don't worry about it too much either.

 

From what I know about qEEGs, you would either have to have an extremely aberrant wave pattern, or would need before and afters. It isn't that smacking your head can't cause trauma, but it is usually repeated smacks that are the problem; and the one time brain joggling that soldiers undergo with IEDs is massive, much more movement that you would get with the average bang to the head.

 

Plus, with a tonic clonic, sometimes it is hard to tell even if you hit your head in such a way as to cause damage, because you just suddenly drop. Of course, one of the most dangerous things about tonic-clonics is the fall. But my husband has hit his head multiple times on concrete when he dropped, including one case when he was seated, and pitched forward flat on his face onto pebbled concrete. He has had big goose eggs, and severe cuts that left scars. But they found no evidence of TBI even on his MEG, which is amazingly sensitive. You probably won't get an MEG, they run about 90k a pop in the US, but he was about to have brain surgery, so they wanted the best possible map they could develop.

 

It was a good idea for them to keep you for a few nights, but you seem to have been okay.

 

Do you think your "baseline," however screwed up that may be, has changed since the tonic-clonic? Or do you think this triggered all of your problems? Seizures are scary and traumatic to witness, but really don't tend to be very harmful in and of themselves. If you have no history of seizures, and have a clear cut explanation for what triggered this one, it is unlikely that you need to worry about the seizure itself. The exception to this would be if your seizure lasted for 15+ minutes, which might mean you had reached Status, which is about the only way a seizure can create new damage. They probably would have told you if you had.

 

When do you have your next neurology appointment? Or your next pdoc appt? Since they are familiar with you, they are going to be most aware of any deficits.

 

Keep notes, but don't work yourself up. It is what it is, and freaking out about it won't help. Whatever the underlying problem may be, you write clearly, and show no deficits in terms of grammar or syntax.

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Given this information and the information in your other post, you really might consider consulting with a neurologist or neuropsychiatrist instead of a regular psychiatrist. You seem to suspect your issues are more neurological in origin and the neurologist would be a way to rule out issues originating from the hardware and wiring.

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Hey guys. Feeling pretty odd at the moment (been kind of sloppy with my sleep of late) so I'm not up to responding at length just now. Hugely appreciative of the thoughtful and extensive responses though, you're a lovely bunch and I feel a lot less panicked and stressed for it. I've resolved to see a neurologist as soon as possible and will be consulting a GP tomorrow for a referral.

 

Just curious as to whether a "neuropsychologist" would be an appropriate person to see? There seems to be plenty of them around in Sydney but it doesn't seem like they're qualified to prescribe medications/other treatments. But I guess the implication is that they'd be able to refer to whatever agency is responsible for that stuff if they determine it's necessary.

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Generally (atleast here in the US), psychologists & neuropsychologists are PhDs and not MDs. MDs can prescribe medications, while PhDs can not. However PhDs research & advance the knowledge of the direct problem rather than treating the obvious existing problem, unlike MDs.

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