Diagnosed With Post Concussion Syndrome. Will This Lead To Multiple Sclerosis?

Posted on Sat, 2 Mar 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 2 Mar 2013 Answered on

Tue, 19 Mar 2013 Last reviewed on

Question : I sustained a concussion 4 years ago and have been diagnosed with Post concussion syndrome: fatigue, headaches, dizziness, nausea, etc. I am 60 years old now. I was told that I would never get over this. However, I seem to be getting worse. The fatigue is increasing getting worse. I sleep for days. Last time I went to the store got very fatigued to the point I couldn't lift my legs and got slack XXXXXXX I ended driving home at 20 MPH and could hardly stay awake. This scared me. Heat bothers me too. I have been depressed with this condition and am on Lexapro 20 Mg. No druges seem to work and I cannot tolerate speed like drugs. Tried Modifil and was way too manic. I am worried now that I may have MS. Can a concussion bring on MS?

Answered by Dr. Sudhir Kumar (6 minutes later)

Hi,

Thank you for posting your query.

First of all, I would like to reassure you that concussion would not lead to symptoms and age, MS is unlikely.

At this stage, in addition to post concussion syndrome, we should exclude small vessel disease of brain, where there are very tiny areas of decreased blood flow, which could lead to similar symptoms. This can be excluded by an MRI scan of brain.

I assume that your TSH level is normal. Also, vitamin B12 and vitamin D deficiencies could lead to similar symptoms at times, so, if not checked already, you may get your blood tested for the same.

I hope it helps. Please get back if you have any more queries.

Wishing you good health,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (26 minutes later)

Thank you Dr. XXXXXXX that relieves me greatly that it is unlikely I have MS. However, I am troubled by my worsening symptoms.
Is is normal for symptoms to worsen with PCS? If I have to live with PCS, I can, but my worsening condition leads me to believe it may be something else.
Also, if I have small vessel disease of the brain, can it be treated? What is the prognosis for this. They have found white spots in my brain matter previously.
Do you have any suggestions to help with fatigue. I drink Coke and that helps sometimes. I have been living with PCS, but the incident in the store was the first time I could hardly walk. I must tell you that I had spent the previous day in bed from fatigue and stomach problems.
Yes, I just got checked for thyroid and it check out OK with my current Medicine. Also had Vit. D checked last year.
Best Regards, XXXXXXX

Answered by Dr. Sudhir Kumar (7 minutes later)

Hi Ms XXXXXXX

Thank you for getting back and providing more information.

I agree with you that it is uncommon for post concussion syndrome to get worse over time. Most often, they get better or at least stay the same.

So, we need to look for alternative causes.

White spots on the brain in MRI are a common finding in small vessel disease.

If diagnosed, small vessel disease can be treated with drugs such as aspirin and statins, along with physiotherapy.

Regarding fatigue, do you get adequate sleep at night, or do you have snoring? As that too can contribute to daytime fatigue and somnolence.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (13 minutes later)

Dear Dr. XXXXXXX
I do not often sleep well at night, especially when I sleep during the day. I often lay there a lot, thinking, etc. until I fall asleep. I try to stay up longer when I have slept during the day, but sometimes I don't feel well and want to go back to bed.
I do not snore, but my husband does. He sometimes keeps we awake.
Also, I have disrupted sleep. My dog get me up two or three times in the night because she has to go out.
Can drinking wine make this situtation worse? I have a couple glasses in the evening with dinner. Have done this all my life, but wonder if the alcohol makes my situation worse.
I forgot to tell you, i have a foggy headed feeling a lot of the time. And often times, when I get up, eat and have some coffee, have to go right back to bed because of feeling sick with nausea and fatigue. On these days, will be in bed most of the day, and get up only to eat, etc.
Thanks much, XXXXXXX

Answered by Dr. Sudhir Kumar (32 minutes later)

Thank you for the additional information.

Improving night sleep, by whatever means, would help in reducing day time fatigue.

Alcohol can play a part, but since you have had it for long, stopping or reducing is also not a straightforward thing. But if everything else does not help, we may have to pay attention to this habit.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar