Masquerades of Brain Injury. Part IV: Functional Disorders.

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Heilbronner, R.L., Martelli, M.F., Nicholson, K. & Zasler, N.D. (2002)

The Journal of Controversial Medical Claims, 9, 3, 1-7.

Patients presenting with significant functional disabilities after seemingly mild injuries represent complex assessment challenges for physiatrists, neuropsychologists, and other rehabilitation professionals. At a minimum, clinicians must have an understanding of the pathophysiology and neurobehavioral sequelae associated with MTBI. They must also have a familiarity with other more 'traditional' psychiatric disorders to assist in differential diagnosis, as well as admixtures. Data from neuropsychological testing, in combination with other objective and subjective psychological data (e.g., a thorough history, clinical interview, review of school records, reports of collaterals, etc.) and information from other medical disciplines, promises the greatest method for differentiating between premorbid factors and post morbid residua secondary to an accident/injury. Many cases of mild head trauma are not simple or clear-cut, but consideration of some of the other functional disorders mentioned in this paper may lead to a greater understanding of some of the complexities involved in differential diagnosis and provide a better foundation for rendering opinions about the causes, needed treatment, and eventual prognosis of symptoms following an accident that purportedly involves MTBI.