My sister fell down some stairs in March 2012. She was rushed by air ambulance to the hospital with a traumatic brain injury. Ever since her fall, she can no longer taste or smell anything. Her hands and feet are always freezing cold. Will her taste or smell ever come back, and why she is so cold all the time?
Loss of taste and smell has been reported to be as high as 25 percent after traumatic brain injury. The loss of taste is generally due to loss of smell. Loss of smell has many possible causes including injury to the nose, nasal passages, sinuses, olfactory nerve, and the brain. The olfactory nerve brings the sensation of smell from your nose to the brain. Since this nerve passes from the nose to the brain, it is at high risk of injury when there is trauma to the head.
There are some medications that can also cause impairments in smell or taste that are commonly prescribed for people with traumatic brain injury, including some antidepressants, seizure medications, antipsychotics, muscle relaxants, and narcotic analgesics. A close evaluation by your sister’s physician is important to make sure there are no reversible causes of loss of taste and smell. If her senses of taste or smell have not returned a year post-injury, it’s unlikely, unfortunately, that they will.
Click here to see BrainLine’s video with Dr. Greenwald on the topic of changes of taste and smell after TBI.
As far as feeling cold all the time, it has become recognized that there can be changes in hormones after traumatic brain injury. A careful assessment of your sister for reasons she feels so cold should include blood tests that measure her hormones (thyroid, cortisone, sex related hormones, and growth hormone).
Please refer to this comprehensive article regarding the treatment of headaches.
More on TBI-related headaches.
Spasticity is another cause of pain more commonly seen after moderate to severe brain injury.
Watch this video with Dr. Greenwald about TBI-related spasticity.
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.