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Traumatic Brain Injury Rehabilitation

By Barbara Eastcairn

Traumatic brain injury rehabilitation is an enormous field. This article focuses on information about forms of rehabilitation that may not immediately come to the attention of people, whether carers or sufferers themselves, who are searching for help.

In particular we will look at rehabilitation for hearing disorders, emotional and cognitive difficulties, and physical effects such as sleep disorders and agitation. These are some of the most common effects associated with traumatic brain injury, or TBI.


The brain’s ability to filter out sounds is a specific sophisticated system that can be destroyed or damaged by trauma and other factors, causing hyperacusis (abnormally acute hearing). Tinnitus is also common with TBI, though the sounds heard vary.

The use of ‘non-linear ear plugs’ can allow one to hear someone talking yet muffle the rest of a room. These plugs stop what is often described by people with brain injury as ‘sound hurting’.

The use of ‘noise generators’, when used over time, may help kick start auditory filters and reduce tinnitus.

A ‘FM stereophonic radio aid’ is a device that some people with brain injury use at important appointments as well as for watching television. This equipment can make an enormous difference in the accuracy of picking up information.

Cognitive difficulties

Quantitative EEG (QEEG) is an analytical method that provides evidence about the brain’s micro-structure and function.

The rehabilitation linked to QEEG is neurofeedback, which is described as a way of measuring and recording electrical signals from the scalp, and using the frequencies of those signals to guide the speed of a feedback signal back to the brain that is provided by a set of tiny ‘transducers’. The feedback makes it easier for the brain to function well, improving mood and cognitive functioning, and decreasing fatigue.

Clients with mood disorders, impaired memory and concentration and a good pre-injury level of functioning can respond well to this treatment.


Psychiatrists are the ‘experts’ in altering behavior or emotion with the use of medications that affect neurotransmitters. It can appear to be semantics to say that someone has a mood disorder caused by trauma that displays the same symptoms as depression, but it is an important difference for many people with traumatic brain injury. This kind of understanding can make it easier for people to be persuaded to take the medication that they need.


Sleep disorders can be associated with brain injury and explain some of the fatigue associated with the condition.

TBI can mean that REM and deep sleep is disturbed and the person be aroused hundreds of times a night. This results in the sufferer being constantly tired or irritable during the following day. Medication can help, and for instance gabapentin can make a difference to some people. It is important to realise that trauma induced sleep problems are unlikely to be helped by a behavioral approach, which is sometimes offered by psychologists.


Agitation in TBI is common, but it can be caused by drugs rather than by the trauma.

For instance, agitation may result from or be increased by the use of some prescription medications, for example Arapax or Ciprimil. Finding the best medication takes time and it is essential that prescribing is done by a specialist with experience in traumatic brain injury.

See severe-brain-injury.com for more resources and information about traumatic brain injury rehabilitation.

Barbara Eastcairn writes about brain injury and other important health issues.

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