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Mental Health (Expert Forum)
Head Injury
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Head Injury
by Leah77, Jan 14, 2006 12:00AM
Hi, okay I'm wondering what you think about this:
In 2002, I had a head injury that resulted in a concussion. It happened because I was out in the wind, standing in my car door, and my car door slammed shut into the left side of my head at the temple, and then my head "bounced" from the door's impact and hit the frame of my car right at the right temple. For three months, I could hardly stay awake, had memory problems, vision problems, depression, coordination issues, etc. I went to the family doctor who dx'd a concussion but didn't do a CT scan until I went back the second time when the fatigue didn't stop after 3 months. The fatigue has never completely gone. At some point during this time I also noticed that my hearing had gotten worse, especially in my right ear, and I had constant tinnitus.
About a year later in 2003, I began experiencing mood swings which were eventually dx'd as bipolar disorder not otherwise specified. I also began suffering from a severe anxiety disorder. I have been on various meds for those since.
About a year after that, in 2004, I began having seemingly-neurological symptoms - pain in my neck, arms & legs, numbness, lightheadedness, trouble walking, vertigo, nausea, dizziness. It became impossible to work or really even to leave my house for long. I saw a neurologist who did a lot of testing (blood, EMG, MRIs, all negative, except a tilt table test, borderline positive & allergy tests, positive for common moderate outdoor allergies) and dx'd conversion disorder. He believed that the fact that I was in grad school & suffering from bipolar & anxiety disorders was causing the physical symptoms.
The fatigue & pain were dx'd as fibromyalgia.
The symptoms eventually tapered to the point where they mainly consisted of vertigo, tinnitus, fullness in my ears & hearing loss. I saw an ENT & told him of my med history. He did a hearing test & found bilateral mild low-frequency hearing loss. He gave me a diagnosis of probable Meniere's Disease, and wanted me to return for more testing. At that point I decided not to - the tilt table test had resulted in a month of constant dizziness & I was figuring that the tests he wanted would be negative as well. So I stopped going to doctors, & eventually the symptoms for the most part went away.
Now I still have occassional stress-related IBS. I also have an anxiety disorder controlled by meds & I still take the bipolar meds though no symptoms. I still have more fatigue than I'd like but that could be med-related. Everything else (except as below) is better.
I still have tinnitus & hearing loss. A second audiogram has duplicated the first results. I have had to get accommodations at work in order to accommodate the hearing loss & keep working.
Do you think that conversion disorder could still be responsible for the hearing loss? Could it be medication related? Do you think the head injury could have played a part in any of this?
Thank you :) Grace
In 2002, I had a head injury that resulted in a concussion. It happened because I was out in the wind, standing in my car door, and my car door slammed shut into the left side of my head at the temple, and then my head "bounced" from the door's impact and hit the frame of my car right at the right temple. For three months, I could hardly stay awake, had memory problems, vision problems, depression, coordination issues, etc. I went to the family doctor who dx'd a concussion but didn't do a CT scan until I went back the second time when the fatigue didn't stop after 3 months. The fatigue has never completely gone. At some point during this time I also noticed that my hearing had gotten worse, especially in my right ear, and I had constant tinnitus.
About a year later in 2003, I began experiencing mood swings which were eventually dx'd as bipolar disorder not otherwise specified. I also began suffering from a severe anxiety disorder. I have been on various meds for those since.
About a year after that, in 2004, I began having seemingly-neurological symptoms - pain in my neck, arms & legs, numbness, lightheadedness, trouble walking, vertigo, nausea, dizziness. It became impossible to work or really even to leave my house for long. I saw a neurologist who did a lot of testing (blood, EMG, MRIs, all negative, except a tilt table test, borderline positive & allergy tests, positive for common moderate outdoor allergies) and dx'd conversion disorder. He believed that the fact that I was in grad school & suffering from bipolar & anxiety disorders was causing the physical symptoms.
The fatigue & pain were dx'd as fibromyalgia.
The symptoms eventually tapered to the point where they mainly consisted of vertigo, tinnitus, fullness in my ears & hearing loss. I saw an ENT & told him of my med history. He did a hearing test & found bilateral mild low-frequency hearing loss. He gave me a diagnosis of probable Meniere's Disease, and wanted me to return for more testing. At that point I decided not to - the tilt table test had resulted in a month of constant dizziness & I was figuring that the tests he wanted would be negative as well. So I stopped going to doctors, & eventually the symptoms for the most part went away.
Now I still have occassional stress-related IBS. I also have an anxiety disorder controlled by meds & I still take the bipolar meds though no symptoms. I still have more fatigue than I'd like but that could be med-related. Everything else (except as below) is better.
I still have tinnitus & hearing loss. A second audiogram has duplicated the first results. I have had to get accommodations at work in order to accommodate the hearing loss & keep working.
Do you think that conversion disorder could still be responsible for the hearing loss? Could it be medication related? Do you think the head injury could have played a part in any of this?
Thank you :) Grace
Doctor's Answer
by Roger Gould, M.D., Jan 16, 2006 12:00AM
, Jan 16, 2006 12:00AM
If the diagnosis by ent doctor was low level bilateral loss of low frequency, it is more likely a middle ear problem like otosclerosis than anything else. At least that would be my guess, and would recommend follow up on that first. That is also very correctable.
Lithium (for short time in 2003, made me feel sick, so dr switched it)
Depakote (2003-2004, dr switched when neuro symptoms began)
Lexapro (2004 to present)
Buspar (summer 2005 to present)
Trileptal (2004 to present)
Flexeril (2004-2005 as needed for muscle pain)