There are a range of potential causes of physical discomfort following brain injury. Due to cognitive and/or communication impairments, patients may be limited in their ability to understand their symptoms and/or effectively seek help. Therefore, physical symptoms may manifest as frustration and/or distress. Even without physical causes of discomfort, the patient may present with anxiety and/or agitation associated with limited insight into their impairments (especially if these impairments lead to others imposing restrictions on them). Contributing factors to distress may include the following:
- Pain and/or physical discomfort.
- Confusion
- Cognitive and/or communication impairment.
- Adjustment Difficulties (e.g. to unfamiliar hospital environment, impairments and restrictions).
- Pre-injury personality and/or psychological difficulties.
- Withdrawal syndromes related to pre-existing alcohol and/or substance misuse.
- Paroxysmal Sympathetic Hyperactivity/Dysautonomia
