Persistent Neurological, Dissociative, and Amnestic Symptoms Following a Mild Traumatic Brain Injury in an Adolescent: ... 2023 Leczycki et al

[Andy]

Full title: Persistent Neurological, Dissociative, and Amnestic Symptoms Following a Mild Traumatic Brain Injury in an Adolescent: A Complex Case of Conversion Disorder

Abstract
The diagnosis of conversion disorder may be given to patients with unexplained neurological symptoms after the exclusion of medical and organic etiologies, suggesting a psychiatric etiology. It requires a thorough examination of all contributing factors across the biopsychosocial model. With a variety of possible presentations, the evaluation and treatment of conversion disorder should reflect its complexity. This case report describes a case of conversion disorder complicated by mild traumatic brain injury and acute psychological re-traumatization in an adolescent with social anxiety and focuses on the connection between symptoms of conversion and dissociation with trauma and memory to form an understanding of the unique presentation and treatment of this condition.

Open access, https://www.cureus.com/articles/173...cent-a-complex-case-of-conversion-disorder#!/

 

[Ash]

It’s so mild, that we like to call it a traumatic brain injury. TBIs, are a bit much, so instead we focus our attention on the word mild. Mildness, is a symptomless phenomenon. We know this from our expertise, our consensus if you like.

 

[rvallee]

But, they're not unexplained. It's absurd to decide, without any basis, that brain injury does not explain... neurological symptoms? What even is this nonsense? It's really as if nothing at all matters in this ideology. Everything is permitted, no matter how ridiculous and obviously invalid.

For sure they are abusing the hell out of the "fully" qualifier, especially as it always applies. You can never fully explain anything in medicine. You never have perfect knowledge and full information. This is completely unserious. And there's even a passing mention of what seems to be another fall to the head after the "mild" TBI.

Tried skimming, there's so much useless blah-blah overexplaining things, and it seems that they simply decided that those symptoms could only be consistent with severe traumatic brain injury, not mild. Ah, well, but they did meet the very scientific assessment of "seemed to resolve", so I guess that's decided then, they were not "felt" to explain the symptoms:

It is worth noting that she did have two concussions, presenting to the ED both times with acute, post-concussive symptoms that seemed to resolve but left behind other continually evolving symptoms that were not felt to be directly caused by the concussion.

Anyone who follows pro sports understands the cumulative harm that concussions can cause. And pro athletes have the best medical care available, because they are huge investments and outcomes matter a lot to the owners of the teams that signed them.

Somehow they shoehorned in the suicide of a uncle, because why not? They just decided that the recent TBI made some connection with the traumatic falls. Again, because why not? And those sweet, sweet brain-injuring secondary benefits:

In the case of this patient, she could have found comfort in being cared for and being freed from personal obligations immediately following her concussions, and thus unconsciously produced new and evolving symptoms as her initial post-concussive symptoms resolved.

All of this is completely speculative, a bunch of "could be"s, "may have"s, "perhaps"es and "it is possible"s. None of this is valid, it's complete pseudoscientific asinine guesswork working out of a preferred conclusion and grasping at straws to justify it.

 

[SNT Gatchaman]

Mitochondrial dysfunction underlies impaired neurovascular coupling following traumatic brain injury (2023, Neurobiology of Disease)

PRMT7 can prevent neurovascular uncoupling, blood-brain barrier permeability, and mitochondrial dysfunction in repetitive and mild traumatic brain injury (2023, Experimental Neurology)

Non-coding RNAs and Exosomal Non-coding RNAs in Traumatic Brain Injury: the Small Player with Big Actions (2023, Molecular Neurobiology)

Neurovascular Coupling by Functional Near Infra-Red Spectroscopy and Sport-Related Concussion in Retired Rugby Players: The UK Rugby Health Project (2020, Frontiers in Human Neuroscience)

Low cerebral blood flow is a non-invasive biomarker of neuroinflammation after repetitive mild traumatic brain injury (2019, Neurobiology of Disease)

Neuroimaging after mild traumatic brain injury: Review and meta-analysis (2014, NeuroImage: Clinical)