Recovery with Deficits in Mild Head Injury and Post-concussion Syndrome Patients
Mild Head Injury or Post-concussion Syndrome Patients with complaints of cognitive memory or attentional deficit after mild head injury without loss of consciousness frequently present for psychiatric evaluation for worker’s compensation and disability benefits. Objective evidence of brain dysfunction in such cases is critical in the endeavor to separate the truly dysfunctional patient from the malingerer. EEG/QEEG evidence can play a critical role in such cases.
Although the absence of abnormal brain electrical activity cannot definitively exclude the possibility of brain dysfunction, the presence of abnormalities, especially those most frequently associated with unequivocal traumatic brain insult, must be considered supportive of such claims.
There is a high incidence of diffuse axonal injury, about 50%, in the 50,000 patients per year with head injury who recover; these patients characteristically do not display structural lesions on CT or even on MRI scans early after injury.
Among those who recover after moderate head injury, 90% have cognitive or neuropsychological deficits.
Among such patients, studies involving many hundreds of cases have reported normal neurologic examinations but abnormal EEG.
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Conventional and Quantitative Electroencephalography in Psychiatry
John R. Hughes, M.D., Ph.D.
E. Roy John, Ph.D.