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CHRONIC PAIN 1997

PRACTICE POINTS:

Impaired concentration, memory and attention are common accompaniments of Chronic Pain and do not necessarily imply physical injury to the brain

Physician judgments of severity of pain and disability are demonstrably biased by adequate medical explanation extremes of intensity negative patient-doctor relationships

The "thin skull" profile, which should be established for Chronic Pain clients includes

1. Alexithymia ("no words for feelings")
2. Depression-proneness

The Chronic Pain-killer efficacy of Antidepressant medications is independent of the presence of Depression

Spinal Cord Stimulation by implanted electrodes is becoming a viable option for localised Chronic Pain

BURYING MISTAKES

PRACTICE POINTS:

Autopsy studies suggest that up to 10% of principal diagnoses are seriously erroneous

Because the range of clinical features of any disease is so wide, one disease sometimes masquerades as another and major diagnostic errors may be inevitable

PAP SMEAR ERRORS

PRACTICE POINTS:

Pap smear negligence litigation is frequently successful

TRAUMATIC BRAIN INJURY 1997

PRACTICE POINTS:

Victims of Traumatic Brain Injury tend to underrate their physical disabilities and are generally accurate in estimates of their levels of cognitive and social functioning

Drug and alcohol use must be considered when interpreting both neuropsychological testing and Event Related Potentials results during recovery from TBI

TBI patients are more realistic about their related alcohol problems than is generally believed

Studies reporting rates of return to school or work after TBI may be systematically over-optimistic because large numbers of substance abusers are lost to follow-up

Factors in the 50% probability of marital breakdown include length of

1. post-traumatic amnesia
2. pre-injury relationship
3. time since injury

MVA clients with upper body Chronic Pain or cognitive problems should be investigated for undiagnosed MTBI?

GLOSSARY: Click on the appropriate letter

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