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Fatigue After Brain Injury: Getting Tired of Being So Tired
Brian D. Greenwald, MD, BrainLine
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.
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Brian D. Greenwald, MD,
Dr. Brian Greenwald is currently the medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute (www.njrehab.org). He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School and is also the medical director for Rehabilitation Specialists, a day and residential program for persons with brain injury, in Fair Lawn, NJ (www.rehab-specialists.com).
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Comments [7]
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.
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.
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.
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!!
Try looking into Maca to address Endocrine imbalance problems.
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.
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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