QUESTION:
Dear Dr. Heller,
My father-in-law was recently injured when a fork lift fell on him at work. He
received a major head trauma and some cracked vertebrae. Since the accident, he has been
going into periods where he has seizures that last hours. The symptoms are nearly the same
as a stroke victim. They seem to be the same as what I read for TIA's. We wouldn't let
them do an MRI on him because the radiologist advised against it due to gunshot fragments
in his skull. It was a magnetic MRI which could cause the metal to melt and kill him. Now
the doctors are really mad and won't run any tests on him. They say he is depressed and
has Conversion Disorder. I find that hard to believe because these symptoms were never
present before this accident. They have, however, been present since the accident
occurred. I feel that the doctors are just sticking him with a diagnosis to get him out of
the way and send him home. He does have something seriously wrong and we need to find out
what that is. If there is anything that you could tell me about what your opinion would be
in this situation, it would be greatly appreciated.
Thank you, Lindy
ANSWER:
While some neurological trauma may be indeed present, the likelihood of a psychiatric
problem complicating the picture is high. I assure you he'll be easier for
neurologists to sort out once any underlying psychiatric problems are successfully
treated.
What I do for individuals in this setting is to aggressively pursue the screening test. I look for symptoms that were present
before the injury as well as after the injury. Sometimes many family members and friends
are required to help in this process of making the diagnoses. You'd be surprised at
the number of people who "didn't have problems before" did have problems
before, they just weren't as severe or as easy to recognize. I wouldn't discount
the possibility of psychiatric problems before the injury, or of panic disorder now.
It's also wise to make sure underlying problems such as low B12 or folic acid, and
thyroid problems are not present. Information on these problems is available in my books
and in the
Newsletters section of this Website.