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Recovering from brain injury

I am a 34 y/o female with no medical history untill 4 years ago.  I had back to back concussions( with in a week)with the second one knocking me out for about 20 minutes.  Didn't notice anything different untill 4 months after the accident.  Went to several doctors, and finally found a neurologist that started me on aricept.  It has been 6 months since I have started this drug, and have seen a huge improvement, on memory, concentration, and problem solving.  Even with the improvements, I still have some problems/ with understanding people, complex projects, getting from one place to the next, dizziness, and word finding.  Will these things improve to like they were before the accident?  If aricept is stopped will the other things that have improved, worsen?  I want to be the person I used to be, to be able to function, and live the life I used to have, but I don't understand what is taking so long.  Any information is appreciated.
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Avatar universal
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
    The symptoms and story that you provide are typical for post concussive syndrome that occurs after traumatic brain injury (TBI).  This syndome includes mental dullness, poor memory, depressed mood, personality changes and feelings of lightheadedness and dizziness.  These symptoms are thought to be due to frontal lobe and temporal lobe damage that often occures with TBI.  These symptoms do generally improve with time (to some extent at least), but many patients with TBI have permanent  troubles with the above symptoms.  The use of Aricept (Donepezil) have given hope to many patients for a faster and more extensive recovery (but often not a complete recovery).  The extent of time and the amount that you would potentially relapse if the Aricept were stopped depends on the extent of your injury.  As long as you are not having side effects I would continue the aricept until you feel closer to your baseline.  I would also suggest an MRI of the brain to help determine the extent of your injury.  
I hope this has been helpful.
Helpful - 0
144586 tn?1284666164
I shouldn't be too hard on your physician. I am sure he isn't a monster. The problem with medications such as you are taking is that the natural organs that supply these substances tend to atrophy when high levels of the substance is present. Such drugs often interfere with signaling mechanisms. Sometimes these injuries are permanant, but at your age, the chances of natural recovery are excellent. Good nutrition (especially B-12 and folic acid) and calcium, magnesium and D-3 and plenty of daily exposure to genuine sunlight would be a good start. Just in case it seems as I fell off a turnip truck the criterion for a United States Patent and FDA approval are different. The patent does not require a double-blind study. Gop get the DVD movie "The Constant Gardner". Also, these opinions do not in any represent the sponsors of this board or the affiliated physicians. They are merely mine, and my old lady constantly assures me "your opinions are worthless". Do the prudent thing and go to the PDR (Physicians desk reference). Read up on the drug you have been prescribed and do your own risk benefit analysis.
Helpful - 0
144586 tn?1284666164
I can see no reason on planet earth for you to be on aricept and about six thousand reason why should should not be on this drug. It improves acetycholine levels and is approved for the treatment of Alzheimers, which you certainloy don't have. Improvement in microcirculation helps, and ordinary organic chocolate improves oxygenation levels by ten percent in some studies. Pomegranite juice and extracts and co-enzyme Q-10 will also help. The impact from a concussion induces swelling and there is a window of opportunity to reduce that swelling which impinges on blood flow. When you exsceed the warm ischemic time for cells they die and you get what is called an "infarct". Fortunately there is reduncancy in the brain and you need time for other parts of the brain to assume the duties of the dead cells and re-wire themselves. I believe you would have improbed just as well without the aricept and it is beyond my powers of reasoning why anyone in their right mind would prescribe this drug unless you have become involved in a "drug study", for which many physicians are paid big bucks to find patients in order to have a drug get a patent for a "new use".
Helpful - 0
144586 tn?1284666164
The way this works with the drug companies (having worked for one in the distant past) is that they pick a patient population that has a condition that is expected to naturally improve over time. Your condition fits that category. They them prescribe an "investigational drug" and when you report "improvement" this justifies sending in a request to the FDA for "new use certification" and the granting of a United States "new use patent" can involve only the improvement of a single patient. Your physician is not doing anything unethical or illegal by doing this, but there are many complications involved in altering acetycholineserase levels, including increased ventricular sensitivity, which is not a very "good" thing.
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Avatar universal
Hi,
   The evalution of a neurobehavioural aspect of head trauma is a big field and its very hard to summarize it in these few lines, but we usually start by classifying the patient clinically into mild, moderate, and severe traumatic brain injury .
      From your description of LOC of 20 min you are in the moderate category (we need more like the hospital chart for the GCS score, any amnesia+ the duration, and the assumed type of injury)
      When it comes to prognosis, we lump the mild and the moderate catigories together because they have much better prognosis than the severe cases.But we need to do some kind of special tests like a detailed neuropsych testing batteries, by a specialised nurse at least, to clearly identify the area of deficits, and correlate it with the  neuro imaging like SPECT scan which is more sensitive than a CT or an MRI in detecting cerebral abnormalities in cases like yours some also recomend a functional MRI fMRI/ PET, though no harm of repeating a routine MRI looking for any delayed changes (ventricular or temporal lobe atrophy).
      T o keep it short, we have to separate the organic damages  from the neuropsycological ones post head trauma , and then we could choose the best stratigy to treat it.

     Bob
Helpful - 0

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