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Sources: Open Arms 1 ACI Health 2 NICE3, Cognitive FX
Post-concussion syndrome can develop after a mild, moderate, or severe TBI. It can also come from brain traumas like carbon monoxide poisoning, transient ischemic attack (TIA), chemical exposure, certain viral or bacterial illnesses, surgery, and more.4. Symptoms of post concussion syndrome has some overlaps with those experienced by people with POTS5 and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Parents of children with PCS or ME/CFS may require safeguarding.6 As symptoms can overlap with trauma, parents are at increased risk of being acussed of child abuse, even by health professionals. This can add to emotinonal, which may already be high if the parent is experiencing caregiver burnout.
PCS vs ME/CFS
Myalgic encephalomyelitis (ME/CFS) and post-concussion syndrome (PCS) share some overlapping symptoms, but ME/CFS is a chronic, complex neurological condition with unknown causes, while PCS is a post-injury condition triggered by a head trauma. While some symptoms overlap, ME/CFS is characterized by post-exertional malaise, which is not a primary feature of PCS.
Here’s a more detailed comparison:
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS):
- Definition:A chronic, complex neurological condition characterized by extreme fatigue that is not relieved by rest and that worsens with physical or mental activity.
- Symptoms:
- Extreme fatigue that persists for at least 6 months.
- Post-exertional malaise (PEM), where symptoms worsen after physical or mental activity.
- Cognitive impairment (e.g., difficulty concentrating, memory problems).
- Sleep disturbances.
- Muscle and joint pain.
- Other symptoms can include headaches, sensitivity to light and noise, and gastrointestinal problems.
- Cause:Unknown, but potential factors include genetic predisposition, immune system dysregulation, and environmental triggers.
- Diagnosis:Primarily based on clinical evaluation and symptom patterns, as there is no specific diagnostic test.
- Treatment:Focuses on symptom management and improving quality of life.
Post-Concussion Syndrome (PCS):
Treatment: Focuses on symptom management and rehabilitation
Definition: A condition that can develop after a head injury or concussion, causing a range of symptoms that persist for weeks, months, or even years.
Symptoms:
Fatigue.
Headaches.
Dizziness.
Cognitive difficulties (e.g., difficulty concentrating, memory problems).
Irritability.
Sensitivity to light and noise.
Sleep disturbances.
Emotional changes.
Cause: Head injury or concussion.
Diagnosis: Based on medical history and symptom assessment, as there is no specific diagnostic test.
Source: Open Arms PCS fact Sheet
Rest, Reduce, Pace
- Written materials for you and your family are available from websites such as: Headway (www.headway.org.uk)
- Brain Injury Australia (www.braininjuryaustralia.org.au)
- Traumatic Brain Injury A to Z (www.traumaticbraininjuryatoz.org)
- Better Health Channel (https://www.betterhealth.vic.gov.au/).
- Tools to be Pain Smart – https://aci.health.nsw.gov.au/chronic-pain/brain-injury
When you think about concussions, you don’t necessarily think about anxiety and vice versa. However, there is a definite relationship between concussion and anxiety.
Concussions create a similar sympathetic nervous system dominance and dysautonomia can be a concern. Where the patient may experience a surge in stress hormones, dilated pupils, fluctuations in blood flow and altered cognitive processing. In addition, their digestive system takes a hit, and they may end up with diarrhea or constipation and food sensitivities that they have never experienced before.7
Some people may find they also experience symptoms that overlap with PTSD.8
Activity intolerance in PCS can overlap with that experienced by some people with joint laxity. This is because there can be an association with POTS in joint hypermobiity syndrome, and also POTS can occur in some people with Post Concussion Syndrome
POTS is a dysautonomia Syndrome
Chronic pain/Central Pain Syndrome is common after a brain injury, but it doesn’t need to stop people experiencing pain from living their lives. With the support of clinicians and carers, and through the use of simple, targeted tools, people with brain injury can learn to manage their pain. The Chronic Pain and Brain Injury Website provides a platform for these tools, and for a range of resources and information to support consumers, carers and clinicians to manage this complex condition.
Tools to be Pain Smart – https://aci.health.nsw.gov.au/chronic-pain/brain-injury
Pain can feel like having a large wall in front of you. Like any brick wall it is made up of smaller bricks that join together and stop you from moving forward. Which brick in the wall do you want to work on first?
Click on the brick to get started
- To learn more about how to use the website and resources click the button below.For clinicians
- To develop a Be Pain Smart plan click the button below. go to https://aci.health.nsw.gov.au/projects/be-pain-smart-plan
Changes to mood can occur, where mood can be worsened by not managing post concussion fatigue
9There is no gold-standard treatment for post-concussion fatigue. However, there are a variety of positive health behaviours that will each gradually improve fatigue symptoms.
They include:
- Getting proper sleep
- Proper nutrition
- Avoiding alcohol
- Regular exercise
- Stress reduction
- The 4 Ps of Prioritize, Pace, Plan and Position
- https://www.openarms.gov.au/sites/default/files/2020-06/mild_tbi_patient_handout.pdf ↩︎
- https://aci.health.nsw.gov.au/chronic-pain/brain-injury/for-clinicians ↩︎
- https://www.nice.org.uk/guidance/ng206 ↩︎
- https://www.cognitivefxusa.com/blog/post-concussion-syndrome-and-post-concussion-symptoms-pcs ↩︎
- Miranda NA, Boris JR, Kouvel KM, Stiles L. Activity and Exercise Intolerance After Concussion: Identification and Management of Postural Orthostatic Tachycardia Syndrome. J Neurol Phys Ther. 2018 Jul;42(3):163-171. doi: 10.1097/NPT.0000000000000231. PMID: 29864098; PMCID: PMC6023605. ↩︎
- https://www.nice.org.uk/guidance/ng206/chapter/Recommendations#safeguarding ↩︎
- https://completeconcussions.com/uncategorized/concussion-and-anxiety/ ↩︎
- https://library.neura.edu.au/ptsd-library/co-occurring-conditions-ptsd-library/physical-disorders-co-occurring-conditions-ptsd-library/traumatic-brain-injury-3/index.html ↩︎
- https://completeconcussions.com/concussion-management/post-concussion-fatigue-expected-or-a-chronic-condition/ ↩︎