Could this be Post Concussion Symptom (PCS)? Please help!

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Hi everyone and happy new year.

Thank you for reading my post and i hope to have some of your input. 

A brief history about me is that i had a appendectomy on end Sept (where i having dizziness) and few weeks later I had a motorcycle accident where i fell to the ground and hit several parts of my body including my head but luckily i had a helmet on. I did not suffer any neck & head pain or lose consciousness.

Few days after the accident (around 3 days), i started to have headaches, sleep problems, having memory issues and sensitivity to loud noises & dizziness which persist till today.

I have had an MRI of my brain twice and the neuro and radiologist says there's nothing wrong and had me on Amitriptyline daily. It has since been almost 3 months from the accident and the chronic dizziness and headaches are affecting me a lot. 

Sorry for the long post and i would like to know if my symptoms are suggestive of PCS? I am very worried if this is something other than PCS and i saw a psychiatrist last week and she fobbed me off with some Lexapro.sadsad

Your comments are highly appreciated.

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  • Posted

    To clarify, did your dizziness start after the appendectomy?  I am wondering if this is the root cause of everything afterwards?

    Eleftherios S. Papathanasiou, PhD, FEAN

    Clinical Neurophysiologist

    Fellow of the European Academy of Neurology

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    • Posted

      Hi Dr.Eleftherios,

      Yes, the dizziness started after the appendectomy. 

      Few weeks later after my accident happened, the headaches started.

      Last week i had an Audiology test (where you need to raise your hand if you hear sounds in the headset) by my ENT and it was normal.

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    • Posted

      After the normal audiogram and the provocatory maneuvers, what was the final conclusion/diagnosis from the ENT doctor?

      Eleftherios S. Papathanasiou, PhD, FEAN

      Clinical Neurophysiologist

      Fellow of the European Academy of Neurology

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    • Posted

      The doctor explained that as we have 3 canals in the ear, some crystals have been displaced in one of the canal which did not cause nystagmus hence the dizziness which i am having.

      As you have mentioned before that BPPV is only confirmed with nystagmus, i am not sure whether this diagnosis is correct. The doctor gave me betaserc for 2 months.

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    • Posted

      As you mentioned surgery in the beginning, I suspected that a prolonged head position during surgery may have dislodged some of the said crystals.  This would be compatible with the normal audiogram.  However, no nystagmus was seen by your doctor.

      Is it possible to send to me a copy of your audiogram?

      Eleftherios S. Papathanasiou, PhD, FEAN

      Clinical Neurophysiologist

      Fellow of the European Academy of Neurology

       

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    • Posted

      It depends on the head position during surgery, and your threshold to have this happen to you.

      The normal audiogram rules superior semicircular canal dehiscense (which would have explained the sensitivity to loud sounds), and also endolymphatic hydrops (Meniere's disease and other related conditions).

      Is the dizziness after the accident the same as the dizziness after surgery, or is it different and how different?

      Eleftherios S. Papathanasiou, PhD, FEAN

      Clinical Neurophysiologist

      Fellow of the European Academy of Neurology

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    • Posted

      It presents itself this way.

      Before accident:

      - Imbalance feeling when walking most of the time 

      - Exacerbated by looking at multiple and fast moving objects with walking

      - Exacerbated by fast head movement to whichever direction

      - Slight intolerance to exercise

      After Accident/Today:

      - Imbalance feeling starts only when walking for awhile 

      - Headache at temples will normally follow dizziness

      - Able to exercise with little dizziness now

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    • Posted

      If I understand your descriptions, your symptoms seem to have been worse before the accident.

      The ability to exercise with little dizziness now, tends to rule out hyperventilation induced nystagmus, which would have been indicative of a peripheral vestibular problem.

      Headache/migraine usually follows vestibular problems, they tend to develop hand in hand.

      The imbalance after walking may be due to your body's efforts to interprete visual, touch and balance information together, and over time (the time during walking) the exhaustion in doing this translates to dizziness.

      I feel that there may be a subtle vestibular problem to explain all the above, but it also sounds like the sort of problem that will lesson over time as your body tries to recalibrate to external signals.

      Eleftherios S. Papathanasiou, PhD, FEAN

      Clinical Neurophysiologist

      Fellow of the European Academy of Neurology

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    • Posted

      Thanks for the information Dr.Eleftherios.

      I have also perfomed the Romberg test and with eyes closed, i do feel like falling at no particular direction but eventually did not. 

      I also noticed that you ask some patients here to take some deep breaths in (slowly or fast?) to check for hyperventilation and i did that as well. After taking in 6 or 7 breaths i feel slightly dizzy. 

       

       

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