I recently interviewed a new client who was being tested at U of M hospital for post-traumatic Parkinson’s and seizures following a traumatic brain injury (TBI) from a truck accident. The client is from Marquette, Michigan, and he has been driving all the way to U of M, as well as to MIND - the Michigan Institute for Neurological Disorders - following his injuries.
I feel terrible for him. Much of his treatment was delayed by doctors that his workers compensation carrier picked for him. But what makes the case notable and holds a lesson for brain injury lawyers in Michigan and other states is the post-traumatic seizures he is now having. The client had what was initially classified as a “mild” TBI — mild being a medical classification that has little meaning to the long-term consequences of the brain injury. Over the past 18 months, his condition has clearly deteriorated, which is what caused his first lawyer to refer the case to my office.
Traumatic brain injury lawyers helping accident victims with seizures or “spells” following a brain injury should know that this is not uncommon. These can occur following mild traumatic brain injury and are described as a form of “post-traumatic epilepsy” consisting of “partial seizure-like symptoms.” It usually indicates the brain is injured and damaged, particularly when there is no history of seizures or spells before the traumatic event.
The client’s TBI started fairly typically. And the early medical records show the classic constellation of traumatic brain injury symptoms, including dizziness, headache, sleep disturbance and fatigue, as well as cognitive symptoms such as deficits in attention, concentration and short-term memory. But the seizures — usually lasting only a few seconds and including incontinence, smell, and extreme fatigue afterwards - are very scary for him and his family. The truck accident victim’s wife reports that he “blanks out” and is then very confused and tired. These seizures can also be extremely dangerous, and even deadly.
About 10 years ago, I was friends with a lawyer who had a similar momentary seizure, not very different from other seizures he had had in the past, but this time he fell forward into a pillow at night with no one around. He suffocated and died. His loss was and is still very sad and tragic.
The story of my friend above shows these partial seizure-like symptoms are very serious. For people who deal with seizures, it effects a person’s ability to drive a car or hold a job. My client in this case is a truck driver, and the FMCSA has strict rules (many of which still unfortunately get ignored) about the health of drivers before they can drive a truck.
Seizures are also a major complicating factor contributing to poor outcomes in the “20 percent miserable minority” of people who have suffered brain injury from car accidents and truck accidents and who go on to have permanent disability. That is hundreds of thousands of people every year who continue to have very serious problems and ongoing disability from TBI. Medicine still has very little understanding as to why so large a segment of TBI victims make such poor recovery, although most of the doctors I talk to say genetics plays a large role here, as does cognitive reserve.
From past cases, and lots of neurologist examinations and cross-examinations of defense IMEs in TBI cases, I’ve learned that an epileptic seizure is caused by the inappropriate discharge of cerebral neurons as a result of brain dysfunction.
In a normal brain, the spread of electrical activity between neurons is restricted. During a seizure, there is an abnormal discharge of electrical activity in the brain. The most noticeable form of seizure is a “general seizure,” in which neurons throughout the entire brain are “activated” inappropriately.
But the majority of post-traumatic seizures are “partial seizures” with a focal region of the brain with abnormal electrical discharge. I’ve been told that in most cases the partial seizures originate in the temporal lobe. The temporal lobe is also the area involved with emotion, memory, olfaction and hearing. Seizures can affect each of these, and the medical records from my client from Marquette do show each of these areas has been affected.
The best advice I can give, as a lawyer who has been helping people with TBI and fighting these battles for almost 20 years, is that it’s really important to have a top neurologist involved in your client’s care, recovery, and rehabilitation. This can sometimes be a problem in our managed care, or in the case above, workers compensation and insurance company case manager driven world.
As scary and disabling as partial-seizures can be for someone who was hurt in a truck accident, they are often missed and poorly documented in the medical records, especially in the beginning. This is because the “spells” are first noted by family, and more often because post-traumatic seizures are overshadowed by more obvious injuries, including physical injuries and the cognitive and emotional troubles arising from a brain injury.
When defense lawyers attack these cases (and often the plaintiff, since with these “invisible injury cases” defense lawyers always try to attack the plaintiff. Ironic isn’t it, how the person who is hurt through no fault of their own because someone else isn’t paying attention is the one who always ends up on trial in TBI cases?), it’s important for the lawyer to explain that partial seizures can explain inconsistent neuropsychological testing.
It helps to know where the defense is coming from in brain injury cases.
Don’t forget to visit Facebook.com/MichiganAutoLaw this week to enter to win a $1,032 check as part of our distracted driving awareness campaign.
- Steven M. Gursten is a brain injury lawyer and head of Michigan Auto Law. He is a member of the American Association for Justice Traumatic Brian Injury Litigation Group. Steve received trial verdicts of $5.65 million and $3.5 million for brain injury car and truck accidents victims in Michigan. Both trial verdicts were the largest reported auto negligence verdicts in Michigan for the year.
Related information to protect yourself:
Steps TBI victims must take after an auto accident
The truth about delayed and missed TBI diagnosis
For brain injury lawyers: Michigan traumatic brain injury law
Michigan Auto Law is the largest law firm exclusively handling car accident, truck accident and motorcycle accident cases throughout the entire state. We have offices in Farmington Hills, Detroit, Ann Arbor, Grand Rapids and Sterling Heights to better serve you. Call (800) 777-0028 for a free consultation with a Michigan brain injury lawyer. We can help.
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