Agitation and restlessness

Abstract: Agitation is an excess of behaviors after brain injury including aggression, restlessness, disinhibition, akathisia, and inappropriate vocalizing. It is often associated with the period of posttraumatic amnesia and typically resolves within 4 weeks. Diagnosis is made once other conditions have been ruled out and is typically assessed clinically. First line management includes environmental and behavior modification. If addition of pharmacologic agent is needed, choice of therapy should be based on clinical presentation and medical comorbidities. Propranolol has the best evidence for efficacy; Antipsychotics and Benzodiazepines should be reserved for agitation/aggressive crisis.