Self-Identity Loss and Brain Injury

The leading story in the Sunday NY Times entitled "After Injury, Fighting to Regain a Sense of Self" describes a condition experienced by a small group of traumatic brain injury survivors. 

After a motorcycle accident and brain injury, a 19 year old lost his ability to recognize his mother.  The article decribes the ordeal.

Doctors have known for nearly 100 years that a small number of psychiatric patients become profoundly suspicious of their closest relationships, often cutting themselves off from those who love them and care for them. They may insist that their spouse is an impostor; that their grown children are body doubles; that a caregiver, a close friend, even their entire family is fake, a duplicate version.

Such delusions are often symptoms of schizophrenia. But in the last decade or so, researchers have documented similar delusions in hundreds of people who are not schizophrenic but have neurological problems including dementia, brain surgery and traumatic blows to the head.

A small group of brain scientists is now investigating misidentification syndromes, as the delusions are called, for clues to one of the most confounding problems in brain science: identity. How and where does the brain maintain the “self”?

What researchers are finding is that there is no single “identity spot” in the brain. Instead, the brain uses several different neural regions, working closely together, to sustain and update the identities of self and others. Learning what makes identity, researchers say, will help doctors understand how some people preserve their identities in the face of creeping dementia, and how others, battling injuries like Adam’s, are sometimes able to reconstitute one.

This and other syndromes of traumatic brain injury account for the cognitive deficiencies following injury.

Another Case of Shaken Baby

A Massachusettes man is charged with shaking his girlfriend's 10-month old baby to death.

Authorities say the boy died at Hasbro Children's Hospital in Providence after being diagnosed with diffuse brain edema and bilateral retinal hemorrhaging, both symptoms of shaken baby syndrome.

Police said Lopez was the only adult present at the apartment when the baby suffered extensive injuries. The baby's mother was working.
 

Heartbreaking.

Reported at http://www.southcoasttoday.com/

The Shaking Baby Debate

As I have been focusing on cases of shaken baby syndrome these past weeks, the December issue of Discover magazine publishes an article entitled The Shaken Baby Debate. Author Mark Anderson raises the issue of how the legal system pigeonholes the issue and, at times, wrongfully prosecutes.

“On one side of the courtroom, representing mainstream medical opinion, are those who believe shaken baby syndrome (SBS) is a valid diagnosis…On the other side, a growing number of skeptics are now claiming that the evidence for the syndrome rests on dubious medical ground with questionable biophysical models supporting it…Each side is battling for the high moral ground.”


Just as in other areas of litigation – you can always get what you pay for.
“Money…has brought otherwise good people over to what…colleagues call the ‘dark side,’ doubting SBS.”
 

Eli Newberger, assistant professor of pediatrics at Harvard Medical School, states, “I have never ceased to be amazed about what highly regarded, well published, scientifically informed doctors will do when they’re offered large amounts of money.”


The advocates of diagnosing SBS base their observations of modern scientific diagnostic technology such as Magnetic Resonance Imaging (MRI). The skeptics, conversely, say that innocent families around the world have been left in ruins by prosecutors and child protective agencies who have wrongfully accused parents and child-care workers of child abuse.


My personal thoughts, as always, make room for salient arguments on both extremes. If the system wrongfully prosecutes even one, then the entire system loses credibility for the rest who then fear similar retribution. However, let us never lose sight of what we are potentially doing by ignoring the signs and symptoms of SBS. The condition is serious and must be so regarded.
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