Author response: Medical retirement from sport after concussions: A practical guide for a difficult discussion

On behalf of my co-authors, we appreciate the letter from Dr. Sethi. In the course of developing our algorithm and manuscript,1 we were careful to be inclusive of the various terms, both current and historic, describing sudden neurologic phenomena following concussion aside from simply loss of consciousness. In our experience, some of these phenomena, particularly “concussive convulsions” (fencing postures and other tonic postures), are not uniformly known by neurologists to be a part of concussions unless the neurologists are involved with sports medicine programs supervising high-risk sports, or very frequently encounter patients with mild traumatic brain injury. The neurologic localization of concussive convulsions, either as cortical or subcortical phenomena, has been a matter of some debate, but these events are inarguably obvious signs of sudden neurologic dysfunction following concussion