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Fatigue following a brain injury

Fatigue is our body’s sign that we need to take a break, and it's normally solved after a period of rest.

Fatigue after brain injury – or 'pathological fatigue' – is different and can be present most or all of the time, and can therefore have a significant impact on the lives of those who experience it. 

Indeed, fatigue is one of the most common problems people report after brain injury. It may cause intense feelings of sleepiness, lack of motivation, lack of energy, none of which is alleviated with rest. It can also mean a worsening of other difficulties related to their injury, including forgetfulness, word finding difficulties, low mood, dizziness and headaches.

In a survey carried out by Headway results showed that more than two thirds of respondents believed that they have been unfairly judged or treated as a result of people not understanding their brain injury-related fatigue, and 87% of respondents felt that fatigue has a negative impact on their life.

What is the cause?

Fatigue after brain injury can be caused by several, or a combination of different, factors. For example, it can arise as a result of direct damage to certain brain structures, or as a result of needing to make more effort to carry out other daily functions such as movement or speech.

However, despite how commonly the symptom is reported, the underlying causes are still relatively poorly understood.

Understanding fatigue after brain injury is, of course, very individual and involves developing an understanding of what any possible triggers may be. Some people report that certain activities, like working at a computer, or being in a busy and overly stimulating environment, can trigger feelings of fatigue. Once any such triggers have been identified, it's then a case of trying to find suitable ways to manage that, for example, trying to limit screen time.

Evidence to support the impact of fatigue

I have represented several clients who have suffered extreme levels of fatigue post brain injury.  This has two vitally important consequences for me. 

Firstly, in all my contact with them, I need to ensure that I understand this aspect of their symptoms so that I am not a trigger or cause of excessive fatigue.  I will always ask the following questions: When is the best time to speak?  How long would you like the call or meeting to last?  How would you like the information and advice I am going to give to you presented?

Secondly, it's vital that comprehensive evidence of the impact of the fatigue is gathered, crucially in witness statements from family and friends and from employers, schools or colleges if relevant, but also by discussing and understanding and then evidencing management strategies with those clinicians who are treating or supporting my client.

Finally, as the incidence of disabling fatigue post brain injury becomes more widely understood, there are a range of specialist fatigue management programmes now available.  Discuss these options with your expert witnesses and ask if they would consider this a reasonable recommendation for your client.  It can be all too easy to overlook the profoundly disabling impact of fatigue after a brain injury; it's vital to ensure that this is fully explored and evidenced. 

Find out more about Irwin Mitchell's expertise in supporting people following a brain injury and their family at our dedicated brain injury claims section.