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Jolie Rouge
05-04-2005, 05:48 AM
By MALCOLM RITTER, AP Science Writer

NEW YORK - Nearly 10 years after a brain injury left a firefighter virtually mute, he suddenly started talking to his wife and sons last weekend. A couple of years ago, it happened with a severely injured car accident victim who'd spent 19 years in silence.

And before that, a paralyzed policeman whose brain had been damaged in a shooting suddenly regained his speech after eight years.

Normally, brain-injured patients who get better do so within the first five years, especially in the first two years, and usually the change is gradual.

So what's the explanation for these reports of long-delayed, sudden improvement?

"We really don't know for sure what's going on," says Anthony Stringer, director of neuropsychology in the department of rehabilitation medicine at the Emory University School of Medicine.

While the answer might involve some long-delayed change in the brain, experts said Tuesday, a sudden improvement might also result from a far different cause, like a change in medications or treatment of some other medical condition that's been suppressing mental function.

Experts say such cases are so rare they don't have much to study, and note that news accounts usually leave out the details needed to evaluate possible causes.

The latest case involves firefighter Donald Herbert, 43, who has lived at a nursing home in suburban Buffalo, for more than seven years.

In December 1995, the roof of a burning home collapsed on him. He went without oxygen for several minutes before he was rescued, and he ended up blind with little, if any, memory. He was largely mute and showed little awareness of his surroundings.

But last Saturday, he suddenly asked for his wife, Linda. And over the next 14 hours, until he fell asleep early Sunday morning, he chatted with her, his four sons and other family and friends, catching up on what he'd missed.

"How long have I been away?" Herbert had asked.

"We told him almost 10 years," said his uncle, Simon Manka. "He thought it was only three months."

A steady stream of visitors arrived at the Father Baker Manor nursing home in Orchard Park to see the fireman, whose plight had been a major local news story when the fire and accident happened.

Herbert's sons were 14, 13, 11 and 3 when he was injured.

Staff members at the nursing facility recognized the change in Herbert, Manka said, when they heard him speaking and "making specific requests."

"The word of the day was `amazing,'" he said.

The nursing home and the family have declined to describe his condition since then or discuss medical details of the case.

There have been a few other widely publicized examples of brain-damaged patients showing sudden improvement after a number of years. In 2003, an Arkansas man, severely disabled and largely silent for 19 years after a car accident, stunned his mother by saying "Mom" and then asking for a Pepsi. His brain function remained limited, his family said months later.

And Tennessee police officer Gary Dockery, left paralyzed and mute after a 1988 shooting, began speaking to his family one day in 1996, telling jokes and recounting annual winter camping trips. But after 18 hours, he never repeated the unbridled conversation of that day, though he remained more alert than he had been. He died the following year of a blood clot on his lung.

None of these people were in a "persistent vegetative state" like Terri Schiavo, the Florida woman whose feeding-tube case raised anguished end-of-life ethical discussions.

So what might explain long-delayed, sudden recoveries from brain injury?

One possibility is that the brain may have been impaired not just by the injury, but by some other condition, such as an infection or unrecognized seizure. When that other condition is treated or removed, the person's mental status improves, even though the effect of the brain injury itself is unchanged.

"Something is holding them down further" than the brain injury itself does, said Dr. Ross Zafonte, chair of the department of physical medicine and rehabilitation at the University of Pittsburgh.

For example, some people have longstanding but subtle seizures after a head injury that can induce confusion, and when they are treated, "Boom, people get better," said Dr. James Bernat, a neurology professor at Dartmouth University. "I've seen that happen."

Liver disease, lung problems, anemia, infections and diabetes can also contribute to neurological problems, he said. So can side effects from certain drugs, and so a change in medication might bring about a sharp improvement in mental status, he said.

"I'm not saying that's the case here (with the firefighter)," he said, "but these are the kinds of details we would need to know in order to properly interpret what happened."

Dr. Jack Parent, an assistant neurology professor at the University of Michigan Medical School, agreed that medication side effects and chronic conditions might suppress mental function for a long time. But he also said scientists have only in recent years come to appreciate how much potential the brain has for self-repair.

If a person's motivation is hampered, he said, "you could look a lot more impaired than your brain actually is." So maybe if neuronal circuitry that lets a person tap the brain's motivational centers was damaged and then gets fixed, that might produce a sudden improvement, he said.

But why that would finally occur so long after brain injury, he said, is a mystery.

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http://story.news.yahoo.com/news?tmpl=story&cid=519&ncid=519&e=3&u=/ap/20050504/ap_on_re_us/firefighter_recovery

schsa
05-04-2005, 12:19 PM
The sad part is that it could reverse itself as fast as it started. That would be horrible.

YankeeMary
05-06-2005, 03:05 AM
I am sure his family is on bent knees. Hopefully he will continue to improve. God Bless them.

schsa
05-06-2005, 03:50 AM
He has been taking neuro stimulators. This sort of reminds me of that movie with Robert DeNiro and Robin Williams when Robin played the doctor that gave all of the polio patients stimulants and they all came back for a short period of time (I can't think of the name of the movie). If you can stimulate the part of the brain that is not responding you have the opportunity to possibly make that part of the brain work again. Researchers are using electronic impulses to relieve major depression by stimulating the part of the brain that helps the synapse communicate.

It is amazing how the brain will respond.

JCshopper
05-06-2005, 04:26 AM
He has been taking neuro stimulators. This sort of reminds me of that movie with Robert DeNiro and Robin Williams when Robin played the doctor that gave all of the polio patients stimulants and they all came back for a short period of time (I can't think of the name of the movie). If you can stimulate the part of the brain that is not responding you have the opportunity to possibly make that part of the brain work again. Researchers are using electronic impulses to relieve major depression by stimulating the part of the brain that helps the synapse communicate.

It is amazing how the brain will respond.


The movie was Awakenings and the drug used was L-Dopa (synthentic-dopamine). Our bodies normally produce dopamine but somehow the synthetics are never the same or long lasting. That just happens to be one of my favorite movies and it is based on a real doctor with real patients. They have also used L-Dopa in parkinsons and Alzheimer patients I believe. They do get results but never permanent. Very sad.