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Dr. Andrew Rynne

Family Physician

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What is brain fog a symptom of?

Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3360 Questions

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Posted on Tue, 12 Jun 2018 in Brain and Spine
Question: To whom it may concern

I have been getting bouts of confusion,dizziness, headaches, pressure in my headand what I can only explain as brain fog ( during these episodes I find that my problem solving and my cognitive function is diminished). The episodes have been happening on and off for the lastyear in which I have had three mri,s a full cognitive function test full set of blood tests ie count,liver,kidney,cardiac panel,arthritis. Sleep apnea test. I have also had a cardiac stress test,24 hour holter monitor,5 day event monitor, echo cardio gram and these have not indicated a problem with my heart or a tumor or other brain defect.

Please can you give advise as to what this could be
doctor
Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
A couple of possibilities, but anxiety could also be a cause.

Detailed Answer:
I read your question carefully and I understand your concern.

While on one hand it must be frustrating and confusing to have all those test and not find anything, on the other hand as you seem to have been thoroughly tested it is reassuring that nothing has come out, no threatening condition.

Among other possibilities to consider would be also thyroid dysfunction and vitamin B12 deficiency, however I suspect that even though you do not mention it, you must have been tested for those as well given the many exams.

Another remaining possibility of such attacks with altered mental function would be that of seizures. For that purpose I think an EEG would be advised as well.

If the above possibilities are excluded though, I would consider the possibility that these events are of a psychological origin, related to anxiety. Anxiety can manifest with many different symptoms, mimicking many other medical conditions. Yours would be a common manifestation and it is a diagnosis to be considered given the exclusion of other possibilities.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 26 minutes later
Thank you for your response I haven’t As yet gone for a EEG. I wanted to check if any of these symptoms could be dementia or another degenerate disease as I also experience so periods of nausea and a pressure in my head with headaches
doctor
Answered by Dr. Olsi Taka 17 minutes later
Brief Answer:
Neurodegenerative conditions very unlikely.

Detailed Answer:
Thank you for the feedback!

The reason I suggested thyroid dysfunction and vitamin B12 deficiency is precisely as those are possible causes of dementia, that is what I had in mind.
However I wouldn't regard it as likely given the episodic nature of the symptoms. Neurodegenerative diseases start in an insidious manner and progress constantly, do not occur in such an episodic manner. Furthermore there usually are some changes on MRI (admittedly imaging is not diagnostic, but it is a however a factor further decreasing likelihood).
As for headaches and nausea, those aren't symptoms dementia or other neurodegenerative disease at all. On the other hand, tension type headache, the most common primary headache (primary meaning with no identifiable cause) as well as migraine are commonly linked with anxiety.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 18 minutes later
Thank you for your response. I can confirm that I do suffer from anxiety but wouldn’t have thought that it could interfere with your cognitive function. Just to sum up the Q&A

The episodes that I have been experiencing are more than likely to be anxiety rather than a degenerative disease
doctor
Answered by Dr. Olsi Taka 5 minutes later
Brief Answer:
Yes

Detailed Answer:
Thank you for the additional information!

Yes, I can confirm that anxiety and depression are common mimics of cognitive dysfunction. They often create the false impression of memory impairment as well but it is a concentration issue not an issue of memory itself.

So I do believe it is a strong possibility, certainly more likely than neurodegenerative disease. It is good that doctors have done all those tests as all other possibilities must be excluded before concluding for anxiety, but if all tests result normal anxiety would be the most likely diagnosis.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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