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Fatigue After Brain Injury: Getting Tired of Being So Tired

Comments [12]

Brian D. Greenwald, MD, BrainLine

Fatigue After Brain Injury: Getting Tired of Being So Tired
 

My 28-year-old son was seriously injured in a car accident two years ago and suffered a critical brain injury. He can't walk and is still unable to straighten his legs. What seems to bother him more than anything is how utterly exhausted he is all the time. He was always such an energetic young man and finds the exhaustion terribly frustrating because it prevents him from working as hard as he would like to in physical therapy. How long will the extreme bouts of exhaustion last?

 

Fatigue is a common problem after brain injury. Estimates of the incidence of fatigue for individuals with TBI range from 50-80 percent. Depression, pain, sleep disturbance, and neuroendocrine abnormalities all have been associated with fatigue after TBI.

You should talk to your son’s physician about this problem so a careful evaluation can be done. Many of the medications that are used to treat spasticity, seizures, and mood can cause fatigue or sleepiness. Sleep disorders are seen in about 30 percent of people TBI even years after injury. In some cases, an overnight sleep study allows you to get a proper diagnosis and decide on treatment. Endocrine problems are becoming increasing recognized as a cause of fatigue. Low thyroid, low adrenalin, low testosterone, and low growth hormone can all contribute to fatigue. There is a lot of current research being conducted on low growth hormone and how to best assess and treat this increasingly recognized problem.

In some people with TBI — if no cause of fatigue can be found — their doctors often consider stimulants. Common stimulants used include amantadine, methylphenidate (Ritalin), detroamphetamine/ amphetamine (Adderall), modafinil (Provigil), and armodafinil (Nuvigil). Make sure you take your son to a doctor who has experience treating people with brain injury and with using these medications.

 

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 [12]

When I was 22 years old I had a car wreck one evening when driving home from college. I somehow lost control of the vehicle and ended up landing in a pasture. After landing in the pasture my vehicle rolled at least nine times, and out of the window I was ejected. I was then taken to the ICU at the local hospital for about a month before I went to Charlotte, NC. In total my stay at the hospitals was for nearly 4 months. I was in a coma for approximately 2 months. My TBI was so severe I was classified as being 3 on the Glascow Coma scale.

The real reason I am writing is to share how great a medication Adderall is. It helped me with my debilitating fatigue as well as helping my conscentration. So if anyone reads this who is experiencing major fatigue from a head injury mention to your doctor about Adderall. It was the game changer that has totally improved my life.

May 13th, 2014 2:31pm

Hi I am 1 of the survivors of TBI and was in a coma for 2wks. It's a long road to recovery, I seen all the therapists I needed to see. Physio, occupational, speech, nuerocycologist, ENT, nurosurgeon and finally I'm training at the gym with a biokinetist. 8yrs have past, I'm still trying very much to get strong physically, and with keeping fit n getting stronger, this helps not to be as tired anymore. I feel that after a TBI experience, u will always be experiencing being tired, it's all about how u control and are able to adjust to ur new life. But the correct diet is also a big +. Hope I was of some help.

Feb 23rd, 2014 3:49pm

I'm a survivor of tbi, which happened nearly 7 years ago, and since then I've had to learn to walk talk and eat again.  In all this time I've never received help from doctors, they tend to shrug me off, but ever since my coma I've been fatigued so much that its stopped my normal life and being soo exhausted has got to the point where I've gained weight i now weigh twice as much as i used to, and fear I'm only going to get bigger as i age.  NO DOCTORS ARE WILLING TO HELP. Its basically a joke!!

Dec 16th, 2013 6:53pm

I had a massive stroke in 2007. I seem to get fatigued easily and no one has done anything to help me.. Sleepy and ignored..

Sep 9th, 2013 6:23pm

Hello. I also suffered a TBI coming up on 7 years ago. My doctor and neurologist don't seem to pay much attention to me when I tell them of my constant exhaustion. I pretty much live on energy drinks. I'm resigned to the fact that this is permanent, though I'm still getting on with what I can

Aug 4th, 2013 6:29am

I agree with the comment made on Jun 20th, 2012. Having suffered a TBI as a child (22 years ago), I have over the years developed 'coping mechanisms' to deal with the fatigue. However I have noticed in the past couple of years that the fatigue is as bad as ever, if not worse. While I know that for each case the extremity of fatigue is different and I have learnt not to talk about it but instead find ways to cope/ hide it. All the best to your son with his recovery

Sep 11th, 2012 9:26am

FYI--the fatigie after brain injury will never abate, diminish, or get better!! I had a tbi 15 years ago--today my fatigue is worse than it ever has been! You must find your own personal way to cope, so the prolonged and endless exhaustion is no longer a consideration. I choose to push through, and ignore it, when possible.

Jun 20th, 2012 3:29am

Energy Medicine is something that is now being explored more and more in the brain injury field as well as other areas of health care. The medical establishment only knows what they have been taught which is basically pharmaceuticals. It is quite encouraging to see people explore other avenues of treatment now. Another point to remember is that the body needs rest for recovery, just a body in a coma, and getting upset over fatigue furthers the fatigue as the worry causes more stress that impacts the body, requiring more rest. Just something to consider.

Dec 14th, 2011 3:36pm

I had a traumatic brain injury in Jan 2009. I experienced severe fatigue since my accident. I went for neuro feedback and neurological chiropractic adjustments ( still attending) two months ago and have been surprised by the results. My fybromyalgia or permanently aching muscles improved immediately, fatigue has considerably eased and my brain fatigue and capability now seems to be improving also. I had no real expectation, was not promised any miraculous cure but something has definitely occured.

Dec 10th, 2011 1:56pm

I suffered a serious horse accident and thus could not finish Harvard. Five years later I found a lady in energy medicine after every possible try in the medical and alternative medicine arenas. I had TREMENDOUS recovery from this!! Learning RX is also phenominal and honestly there are not that many seriously injured that return pretty darn close to where they were before. Feel free to email me at lauraj.campbell45@yahoo.com. I plan on having a documentary about my story and raise awareness as to my recovery and give hope to others!!

Dec 9th, 2011 10:50pm

Try looking into Maca to address Endocrine imbalance problems.

Dec 9th, 2011 1:47pm

Could it be vestibular dysfunction from the impact? Do you have balance issues but they are subtle? I did. Vestibular rehab helped. This is something good Dr's missed. Because. I was having headaches an net ordered a hearing test and vestibular test......the rehab therapy came from own research. On another note I had an optometrist trained in treating brain injury eye issues.

Sep 10th, 2011 6:44pm


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