Post-Concussion Symptoms and Their Duration

Post-concussion syndrome

Hello Dr.
Ding,
I had an accident six days ago while riding my motorcycle too fast and fell.
I was wearing a helmet, but I am unsure what my head hit, and I lost consciousness for about ten minutes.
Over the past week, my bodily injuries have gradually improved, but I have been experiencing a persistent feeling of dizziness in my head for the last six days.
I have not vomited, but the dizziness is more pronounced when I lie down or get up.
How long might this type of post-concussion symptom last? Additionally, is there a high risk of developing epilepsy due to the concussion? How long should I continue to monitor for this risk? If I undergo an EEG or MRI in one to two months, will it be able to determine if my brain and nervous system are normal? Thank you.

ASD, 40~49 year old female. Ask Date: 2013/04/09

Dr. Ding Xianwei reply Neurosurgery

Since I have not personally treated you, I can only respond based on experience.
If unconsciousness lasts more than 10 minutes, it is considered a concussion! Other symptoms are residual effects following a head injury.
Dizziness, nausea, or vomiting are not necessary conditions for a concussion.
In your case, observation should suffice! Regarding epilepsy, it is impossible to completely eliminate the risk.
Since you did not provide detailed information about whether you have experienced seizures, I will respond based on experience: there are two different treatment concepts.
One is to administer preventive antiepileptic medication for at least six months.
The other is to wait until a seizure occurs before addressing it.
If you have already experienced seizures, treatment should follow the standard protocols for epilepsy.
You can discuss appropriate treatment options with your attending physician.
The purpose of examinations is to make medical care decisions, not to serve as a tool to prove normalcy, so I cannot provide recommendations regarding the MRI you mentioned.

Reply Date: 2013/04/09

More Info

Hello! It sounds like you've had quite an experience with your recent concussion. First and foremost, I want to emphasize the importance of monitoring your symptoms closely and seeking medical attention if they worsen or if you experience new symptoms.

Post-concussion syndrome (PCS) can manifest in various ways, and the duration of symptoms can vary significantly from person to person. Common symptoms include headaches, dizziness, fatigue, difficulty concentrating, and mood changes. In your case, the persistent feeling of dizziness six days after the injury is not uncommon. Many individuals report similar sensations following a concussion, and these symptoms can last anywhere from a few days to several weeks or even months in some cases.

The dizziness you are experiencing, especially when changing positions (like getting up from lying down), is often related to vestibular disturbances that can occur after a concussion. It's essential to rest and avoid activities that could exacerbate your symptoms, such as strenuous exercise or activities that require intense concentration.

Regarding your concern about the risk of developing epilepsy after a concussion, it's important to note that while most people who suffer a concussion do not go on to develop epilepsy, there is a slightly increased risk, particularly if there was a loss of consciousness or if the concussion was severe. The risk of post-traumatic epilepsy is generally considered to be low, especially in cases of mild concussions. However, it is crucial to monitor for any seizure activity or unusual neurological symptoms.

As for the duration of observation, it is typically recommended to keep an eye on your symptoms for at least a few weeks following the injury. If you remain symptom-free for a period of time, the risk of developing post-traumatic epilepsy decreases. However, if you experience any seizures or significant changes in your neurological status, you should seek immediate medical attention.

Regarding your question about brain imaging, such as an MRI or EEG (electroencephalogram), these tests can be helpful in assessing the brain's structure and function. An MRI can provide detailed images of the brain to rule out any structural abnormalities, while an EEG can help detect abnormal electrical activity in the brain that may indicate seizure activity. It's generally advisable to discuss with your healthcare provider the appropriate timing for these tests based on your symptoms and clinical history.

In summary, while post-concussion symptoms can be distressing, many individuals recover fully with time and appropriate care. It's essential to follow up with your healthcare provider, especially if your symptoms persist or worsen. They can provide you with personalized advice and determine if further evaluation or treatment is necessary. Remember to prioritize rest and avoid activities that could put you at risk for another injury during your recovery. Take care, and I wish you a smooth recovery!

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