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Hallucinations and Delusions After a Brain Injury

Comments [4]

Brian D. Greenwald, MD, BrainLine

Hallucinations and Delusions After a Brain Injury
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My brother was 19 when he suffered a TBI. He’s made a lot of progress in six years. My family’s main concern right now is that he’s been talking a lot about conversations and events that clearly could not have happened or taken place. He’s also been talking to himself and gesturing like someone is with him — only there is no one around. The doctor has said she’s seen some TBI patients go into their own little world like this.

Our family is obviously very worried and concerned. We don’t want this to set him back especially since he’s come so far. Is this something that can happen to people with TBI and what suggestions might you have for us to help him?

 

Psychiatric issues, including hallucinations and delusions, are certainly more common after traumatic brain injury. The risk for new onset of psychiatric illness after a brain injury goes on for a long time and can be seen with any severity of traumatic brain injury. If these problem are new for your brother, a careful medical evaluation by a physician who has experience in treating patients with TBI is warranted. So the healthcare professional should take a close look at all of your brother’s medications. Some medications can increase confusion or cause hallucination or delusions. Stimulant medications such as Ritalin, Adderall, and Amantadine all have this potential side effect. Evaluation should also be done to ensure these symptoms are not related to seizures.

Loneliness and social isolation can also be contributing factors and should be considered as well.

If no medical or social issue is found and these problems are not bothering him or putting him at risk, I would be cautious about using any psychiatrically active medication. Neuropsychologic and group treatments can be helpful. Neurolpsychologists will evaluation his mood, insight, and judgment to establish if these are true hallucinations or a way of entertaining himself. Couseling can be useful in improving mood. Group therapy would give him a social outlet and can improve insight by seeing others go through similar challeges. If these symptoms worsen and he became a danger to himself or others, medications can be considered. These should only be prescribed by a practioner who has experience in evaluating and treating.

 

Click here to go to About Ask the Expert.

Brian D. Greenwald, MD Brian D. Greenwald, MD, Dr. Brian Greenwald is medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute. He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School.


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Comments [4]

I personally experienced the things you are discussing you actually or I should say I did go thru this rest support limited stress acceptance all play a part

May 1st, 2014 2:20am

i recently had an accident and hit my head severely hard... trying to get doctors to help me has been a struggle.  I finally convinced my doctor to order a MRI which did show some spots on my brain, and am now waiting to see a neurologist.  I have struggled with hallucinations and extreme paranoia and have headaches all the time.  This has also affected my relationship with my boyfriend as I find myself angry a lot.  I pray to God for relief and pray for others that have problems with their TBI

Dec 18th, 2013 12:41pm

Is it uncommon for a TBI patent from 25 years ago, to still go thru anger episodes especially under stress? He is not on any meds but treats himself naturally w/ vitamins/herbs. Also, I see him calling an 'opinion', a 'fact'. For example, If he doesn't like someone (which seems often) - he may call the person a 'jerk'. I will say - 'that is your opinion, I like so and so. He get's angry and says "it's a 'fact' and continuos to defend that it's a "fact", not an "opinion. I and others see there are 'disconnects'. There has been a number of people in & out of his life, from what I have seen, due to anger issues or a breakdown in a relationship due to 'miscommunication' or what seems to be a' disconnect'. Thanks for any thoughts.

Jul 31st, 2013 7:43am

Our son with MTBI has also been talking and gesturing to himself and often gets angry. Medication seems to help, but it's gotten worse lately. As parents, it's very disconcerting and scarey. I don't think his doctors realize how difficult this is to live with, both for him and us. I hope it will gradually go away. I pray to Jesus for healing.

Feb 1st, 2013 8:38am


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