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dr-megasmart
dr-megasmart, Board Certified Physician
Category: Neurology
Satisfied Customers: 15
Experience:  Board-certified neurologist with 21 years experience. Advanced training in epilepsy, stroke, and critical care neurology
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My husband had an accident a year ago at work - oil on the

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My husband had an accident a year ago at work - oil on the floor that he slipped and fell on the back of his head. His employer never called an ambulance even though we were not sure if my husband passed out because he was by himself. A nurse at the employer told him he was fine to drive home. I took him to the hospital where a cat scan was done which was negative. He went to hospital a couple of times and each time the cat scan was negative. He has suffered from headaches, neck pain, concentration issues, short term memory loss and anxiety. He was released to go back to work after a couple of months. He then left that employer and went to a new employer. In December 2012, his neurologist took him off work due to all the above symptoms going on. We are now fighting Workers Comp and was just allowed to have a MRI today which was also negative. His neurologist wants to send my husband back to work with new employer as his FMLA has ran out and they are threatening to let my husband go. The neurologist wants to remove my husband off his meds so that my husband won't lose his job. I asked the neurologist if this was the best for his health/safety she just keeps talking about the economy and about him losing his job. My husband is a machinist that works with a machine that cuts metal. I don't know what to do. The neurologist has never talked about any other tests other than the MRI which was just now done a year later. What can we do now? Should we get a different doctor? Could there have been some damage that might have shown up when the accident happened if we would have the MRi done a year ago?
Submitted: 1 year ago.
Category: Neurology
Expert:  dr-megasmart replied 1 year ago.

dr-megasmart :

Hi, I'm sorry to hear of what you and your husband are going through. Although you're not sure if your husband passed out, do you recall whether or not he was able to remember what happened to him right after the accident and did he seem confused to you? This is important because I think your husband most likely had a concussion. His other symptoms involving headaches, memory issues, and anxiety, are all what are seen with what is called the post-concussive syndrome. By definition, a concussion does not show up on either a brain CT or MRI. Does his neurologist have any ties to his Workers Comp? Do you feel he's giving you his unbiased view on what happened to him? Please let me know so I can provide further information as to the concussion.

Customer:

He was able to recall what happened but he was confused. He told me that he felt as though "birds" flying like the cartoons because it took him awhile to get a thought to call someone to help get him off the floor. The neurologist doesn't have anything to do with the case - but she has asked us about the case before - makes comments like what do you guys want to do or want me to do for you because I am only hear to help you. That is not what she should be doing,,,in my opinion. But instead doing what is best for my husband. One of my husband's eye also looks a little "lazy" or smaller than the other one and he his hands have started "shaking" pretty badly which gets worse with stress. The doctor has him on Vicodin/ Topamar (?) for migraines and now Addarell for the concentration. I'm concerned because now we go back to court with a negative MRI and have to try to fight for financial benefits.

dr-megasmart :

Hi, Thanks for the info. Your husband definitely had a concussion so a normal (negative) brain MRI is to be expected. Didn't this neurologist tell you and your husband he had a concussion? From the description you provided it seems this was a moderately severe one

Customer:

Yes we were told at the hospital that he had a level 2 concussion. What do you suggest that we do now? Should we get a different neurologist? Any other testing? How do we handle a court case - any suggestions?

Customer:

My concern is that how do we "prove" a post concussion syndrome? I am pretty sure that the Workers Comp company are going to say both the CT scan and MRI were negative so we must not be telling the truth. My husband is very upset and stressed out....I'm just not sure what to do to help him at this point.

dr-megasmart :

Hi, sorry, email got cut off. Here's a link to the guidelines by the American Academy of Neurology showing the criteria for making a diagnosis of concussion (http://www.aan.com/professionals/practice/guidelines/pda/Concussion_sports.pdf). You should show this to his neurologist and ask if his symptoms fit the description of the concussion. I would recommend having an electroencephalogram done (measures brain electrical activity at the scalp - can be done either in the neurology office or hospital) and a neuropsychological evaluation to determine the extent of his memory issues. Don't confuse neuropsychological with neuropsychiatric because the former measures his cognitive functions whereas the latter is concerned with things like depression. The neuropsychologic test is performed by a licensed PhD and takes up to 8 hrs or more. Abnormalities on this test may be consistent with concussion. If this is the case, your husband should have an easier time with Workers Compensation (although they can be very difficult as you already know). Ask your husband's primary MD if she/he could refer him to a neuropsychologist. If he doesn't know, look at your insurance provider handbook to see if any of them are listed - they do accept commercial insurance. Or, you can ask the neurologist if she knows someone.

Customer:

Ok, I have heard about the neuropsychological test. I will try that. Just curious....Obviously, you don't know the neurologist that we are using but do you think that she has handled our situation correctly? I think we need a different doctor but not sure.

dr-megasmart :

Hi, it's hard to say, but I work closely with neuropsychologists because I deal with a lot of sports-related concussions (high school and college). Sometimes the only test that's abnormal is the neuropsychologic evaluation. This is a legitimate test that Worker's Compensation cannot dismiss as being irrelevant. I think this, and the EEG, should be the next steps. If the neurologist he's seeing now balks at this additional testing, ask her why? If not, then ask her to make the referral, again assuming she knows a licensed neuropsychologist. Hope this information helps.

Customer:

I appreciate your help. Thank you

dr-megasmart :

You're welcome. Good luck. One other thing - the neuropsychologist will also make recommendations to your husband to help him with his memory problems and she/he will send a copy to your husband's employer but I would first ask the neuropsychologist to discuss with you and your husband his/her findings before sending the report to anyone so that you will know what's in it.

Customer:

ok thanks

dr-megasmart, Board Certified Physician
Category: Neurology
Satisfied Customers: 15
Experience: Board-certified neurologist with 21 years experience. Advanced training in epilepsy, stroke, and critical care neurology
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Board-certified neurologist with 21 years experience. Advanced training in epilepsy, stroke, and critical care neurology