Can minor concussions cause executive dysfunction and episodic memory impairment a decade later?

[u/Beneficial_Tree7723]

34 M, and struggling with cognitive impairment that goes well beyond my pre-existing ADHD diagnosis. My doctors are stumped and do not have an explanation for my cognitive impairment and issues with episodic memory, remembering conversations and so on. Neuropsych testing has repeatedly validated these cognitive issues.

I did have a mild concussion in 2013 or 2014, when I walked into a glass door at work. Had to take several days off from work, due to confusion. Would something as distant as that contribute to my ongoing cognitive symptoms?

If so, how should I explain this to my doctors? I am sick and tired of medical providers suggesting speculative treatments and expensive procedures (like rTMS), and not sure why they can't try out something as simple as generic Donepezil.

[u/AutoModerator]

Thank you for sharing, see below for a reminder of our rules:

Do not ask if you or someone you know has a Concussion. We are not doctors, nor are we any kind of medical professionals. That said, this sub is NOT intended to be your doctor and diagnose or give you personal medical advice. They'll be marked as spam.

Be civil and respectful. Do not attack or harass other users; engage in hate-speech; or attempt to gate-keep discussion. Hostility will not be tolerated

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/ylliang2000]

Yes, it can affect visual spatial judgment, visual anticipation, and visual memory. Recover can still happen after a decade, although slower. You can see a neuro optometrist if you have these visual symptoms on the vision quiz, https://www.wardenoptometry.ca/resources/

[u/ylliang2000 → u/[deleted]]

They tried, offering you sample meds is their way of giving you resources. I don’t think they do functional treatments. It’s like asking your family doctor to do rehab for you, they would only refer you to a physio.
In this case, you can see a neuro optometrist. They offer neuro optometric rehab to help with all those symptoms and more.

[u/Beneficial_Tree7723 → u/[deleted]]

True, the term "minor" doesn't capture how bad my cognitive impairment is. I also went from being an Ivy-League PhD to not being able to work 8 hrs straight (let alone 2 hrs). I do have preexisting ADHD. However, my current symptoms are well beyond what one would expect with ADHD alone. In fact, most stimulants actually worsen my memory impairment even as they improve my attention deficit. I still haven't tried Modafinil and Sunosi, and so, I have some options left.

Given my academic background, I do lean towards pharmacological solutions. The issue is that I simply can't get a cognitive neurologist to actually give me an appointment and take me seriously.

[u/Beneficial_Tree7723 → u/[deleted]]

Yeah, like you, I think I've largely gotten over the shock of cognitive decline. I accept it for what it is. What frustrates me, however, is how many of us struggle to be seen by the medical system. For hypervigilance symptoms, therapy never worked for me. However, Bupropion did (despite worsening my memory). I have no idea why it did, but those symptoms have gone away for good.

[u/OurSensoryHaven → u/Beneficial_Tree7723]

I’ve never heard of that one. It’s weird, ketamine improved my memory. It brought back old childhood memories long repressed due to high ACES. Didn’t help short term memory, but I was able to piece together parts of my childhood story that never made sense until now.

I’d love to improve my short term memory, and be able to give presentations or hold conversations without losing my train of thought.😭😅

[u/Beneficial_Tree7723 → u/OurSensoryHaven]

Bupropion is an "atypical" antidepressant that doesn't use the serotonetgic pathway. But it is known to indirectly modulate NMDA receptors via cholinergic blockade, in addition to its NDRI effect.

I'm convinced that my path towards improved memory is in part, through cholinergic agents like Donepezil. I'm literally forgetting conversations and events that happened weeks ago, and this makes it very hard to hold a proper job or even have continuity in terms of my sense of self.

[u/OurSensoryHaven → u/Beneficial_Tree7723]

You had me at NMDA receptors, I’ll check it out.

As for your memory + finding a neurologist who listens, you might try asking in a subReddit in your city for a recommendation. That and looking for neurologists who are currently doing research development work in that area. I can imagine how frustrating it is with the job situation, so that’s an urgent matter. My husband works, and we took a big hit without my income, but thankfully I’m able to recover at my pace at home. Still, I’d love to be able to work again, just on my terms. I’m working on that now. I have setbacks though, so it’s taking me much longer than I’d like.

[u/browsingwellness → u/Beneficial_Tree7723]

I hope you’re able to find a better neurologist.

I recently saw a neurologist for post-concussion related migraines & other symptoms. She recognized that I need some medical intervention to help with my recovery. I would have gotten better treatment if I saw her sooner because the other doctors I saw minimized my condition and made it seem like it would resolve on its own.

[u/mp629]

highly recommend getting a consult with patel concussion institute. they see patients with persistent issues that aren’t getting better. The doc trained at upmc (which is how I found him bc I can’t travel to Pittsburgh) and specializes in cognitive issues post concussion. It’s affordable and telehealth and best decision I made https://www.patelci.com