Feeling of fog in the head: causes and what to do? Help from a psychiatrist at the ROSA Moscow clinic

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Fog in the head, cloudy consciousness, wobbly head... Today, more and more often, it is with such “vague” complaints that people of different ages turn to the doctor. As practice shows, such a condition can indicate many diseases, but most often it is a manifestation of one of two causes - cerebrovascular accident or neurosis.

At a consultation with a neurologist:

Conducts an inspection;
Listens to patient complaints;
Make a preliminary diagnosis;
If necessary, he will refer you for additional studies, which can be completed in our center;
will prescribe an individual course of treatment.

In each of these cases, the feeling of fog in the head is accompanied by a number of characteristic symptoms and requires its own treatment method.

What is this

“Brain fog” is a symptom that occurs in some diseases, as well as in healthy individuals after overwork or exposure to excessive stress.

The feeling of “fog in the head”, “a feeling of heaviness and futility”, “cloudy perception” and “cloudiness of thinking” is one of the most common complaints, probably familiar to every person. In most cases it is a temporary and completely reversible condition, but in rare cases it is the first sign of the onset of a serious illness.

Most often it occurs suddenly, causes great discomfort, causes anxiety and disrupts normal functioning (interferes with work, study, rest, communication, etc.).

The feeling of fog in the head is one of the components of the asthenic state.

If your head is spinning. Sudden loss of balance is a dangerous symptom

Even the most harmless dizziness at first glance can be a symptom of serious illnesses. Natalya Alekseeva, an otoneurologist, leading researcher at the Scientific Center for Neurology, Doctor of Medical Sciences, told AiF readers what to pay attention to . Yulia Borta, AiF: Natalya Stepanovna, if in the store you feel dizzy not from stuffiness and excitement, then from what?

Natalya Alekseeva: When we tilt and straighten the cervical spine or turn our heads to the right and left, looking at the goods located on the upper shelves, we have to throw our heads back. In this case, normally the cervical vertebrae should shift by 1-2 mm. In the case of pathology (instability in the upper cervical spine), the vertebrae shift by 3-4 mm and impair blood flow in the artery that supplies the vestibular apparatus of the inner ear and vestibular formations in the brain. This causes dizziness. The same thing, by the way, happens when swimming with your head thrown back - a favorite style of many women. And then they complain that after swimming they feel unsteady. These are examples of physiological dizziness. It can also occur in transport, etc. - How to deal with this? — Vestibular gymnastics is necessary - eye movements, head turns no more than 45 degrees and other exercises. But do not overdo the amount of these exercises. It is best to first consult a neurologist or otoneurologist. - It turns out that this is not such a terrible misfortune... - Dizziness is a common symptom, but you don’t need to interpret it yourself. Serious diseases may be hidden behind it. For example, acute dizziness can develop as a result of bacterial and viral damage to the inner ear - labyrinthitis. Usually occurs after otitis. In this case, dizziness is accompanied by noise in the ear and hearing loss. Another possible cause is tumors of the auditory nerve. In young people, dizziness is often associated with viral damage to the vestibular nerve. Those who suffer from ARVI on their legs are especially at risk. Fever, muscle pain, sore throat, runny nose go away, and after a week or even suddenly your head begins to feel dizzy, and along with this nausea and vomiting appear. Dizziness can be caused by acute disruption of blood flow in the inner ear. This happens in people with low blood pressure and a vascular abnormality (small diameter of the vertebral artery).

Dizziness combined with impaired coordination, vision, and weakness in the arm and leg is one of the early signs of a stroke. Even if all these symptoms have passed within 24 hours, you should consult a neurologist. Dizziness and imbalance are accompanied by exacerbation of multiple sclerosis (a disease of the central nervous system). Brain tumors also cause dizziness. This disease is the most insidious. It begins with a slight imbalance: the patient begins to spread his legs wider without noticing it. Violation of stability when turning is also very typical. The patient complains that he turned around and everything swam before his eyes. — What examinations are needed? — Be sure to do an MRI of the brain, determine blood pressure, heart rate, examine blood flow in the arteries in the neck with ultrasound, and conduct vestibular tests. If you complain of dizziness and are prescribed sedative medications, you should consult with another specialist and insist on additional examinations.

A set of exercises to combat dizziness.

Read the article...

Causes

The many causes of brain fog can be divided into two groups: overwork and illness.

Fatigue is caused by:

Exposure to excessive stress.
Lack of sleep, malnutrition (or starvation).
Abrupt change in time zone or climate.
Overload of information, physical labor, strong emotions.
Past diseases and poisonings.

Conditions that cause brain fog:

Psychiatric diseases: schizophrenia, psychosis, depression, neuroses, anxiety and psychosomatic disorders.
Inflammation, fever (increased temperature), infections.
Organic damage to brain tissue (traumatic brain injury, atrophy or brain tumors, strokes and heart attacks), encephalopathy.
Vascular diseases (hypertension, hypotension), intracranial pressure disorders.
Diseases of the cervical spine with impaired blood flow through the vertebral vessels.
Diseases of internal organs, endocrine diseases.

What to do when the head is cast iron?

Headache is one of the most common symptoms. There is probably no person who has not experienced this type of pain at least once in his life.

We prescribe pills to ourselves and take them on the principle of “whatever will help,” without thinking that taking medications for headaches more often than three times a week can provoke a so-called medicinal headache. We put off going to the doctor, without thinking or little understanding of the consequences of a headache.

What is a tension headache? What headache can you not tolerate for a minute? How to treat headaches? We addressed these and other questions to Alexander Sergeevich Tuleninov, a radiologist at MRI Expert Yelets LLC.

- Why does my head hurt and what can be hidden behind the headache?

Headache can occur in patients regardless of age.

According to ICHD-2, headaches that do not have an organic cause are called primary. Secondary (symptomatic) are the result of organic damage to the brain or other structures of the head and neck area, as well as systemic diseases.

— Alexander Sergeevich, tell us more about primary headaches.

One of the most common types of primary headaches is tension headaches. If a patient complains of a “cast-iron head” (“feeling of a hoop”, “cast-iron helmet”), then this is probably the kind of pain we are talking about. Such pains - pressing, squeezing, are a response to muscle tension or psycho-emotional overstrain under acute or chronic stress. Depending on the spasm of certain muscles, the patient may have a headache in the forehead, temples or back of the head.

— What organic causes of headaches are most common?

Among the organic causes that cause headaches are head injuries (both acute and their consequences), inflammatory processes (meningitis, meningoencephalitis, etc.), and space-occupying formations (tumors). Vascular diseases also often manifest themselves as headaches.

Separately, headaches of extracerebral etiology can be distinguished. Such pain can result, for example, from osteochondrosis of the cervical spine. Such pain, both episodic and chronic, is more often unilateral, usually localized in the cervical-occipital region, and can radiate to the temple.

Headache can also occur due to extra-cerebral causes such as sinusitis, glaucoma, and dental diseases.

— We talked about different types of headaches and realized that not every headache, even a very severe one, hides a serious illness. What kind of headache should you be wary of?

If a patient experiences a headache that he describes as the worst pain of his life, urgent medical attention is necessary.

Pain that does not go away for several days, as well as headaches accompanied by neurological changes, for example, drooping lip folds, speech impairment, also require immediate medical intervention.

Headache, the intensity of which increases with coughing or changing body position, is also a concern.

— What should be the treatment for headaches and what specialty does a doctor deal with this category of patients?

If you have headaches, you should consult a neurologist.

Treatment for headaches depends on the causes that caused them and is complex. But any treatment must begin with diagnosis.

— What should a diagnosis for headaches include?

Mandatory diagnostic methods include blood pressure monitoring, general and biochemical blood tests. A test for liver enzyme markers is often prescribed.

Since headaches can be a mask for various diseases, an ophthalmologist, otolaryngologist or dentist may be involved in consultation.

Modern doctors are increasingly referring patients experiencing headaches to MRI diagnostics.

MRI of the brain is the primary research method for headaches, allowing to identify inflammatory processes, liquorodynamic disorders, congenital anomalies, the existence of which the patient did not suspect, and any space-occupying formations.

Carrying out MR angiography of the arteries and veins of the brain evaluates blood flow and also excludes or identifies both gross changes in the blood vessels of the brain that threaten life (such as aneurysmal dilatation), as well as stenosis and thrombosis.

To diagnose degenerative changes in the neck area, an MRI of the cervical spine is performed. In turn, MRI of the neck vessels will reveal stenoses that impair blood supply, resulting in headaches.

— Why undergo complex MRI diagnostics for headaches? If I have a headache, why do an MRI of the cervical spine?

As you can see, there are many reasons that lead to headaches. Therefore, a comprehensive study allows for the most informative diagnosis.

For example, an MRI of the brain, which clearly visualizes any space-occupying formations, does not show vessels, the pathology of which can lead to headaches. As for the neck, we previously said that banal osteochondrosis can cause severe, debilitating headaches for the patient. Therefore, there is a need for a separate MRI of the neck and its vessels. Thus, one study complements the other.

When carrying out MRI diagnostics aimed at identifying the causes of headaches, according to indications, it may be necessary to administer a contrast agent.

- Alexander Sergeevich, so what can you do to stop your head from hurting?

The correct solution in such a situation is to find a cause-and-effect relationship. Therefore, my advice will be banal - do not delay in seeing a doctor.

For reference:

Tuleninov Alexander Sergeevich – radiologist at MRI Expert Yelets LLC.

In 2014 he graduated from the Military Medical Academy named after. CM. Kirov with a degree in general medicine. Afterwards he completed training at the St. Petersburg Pediatric University at the Department of Medical Biophysics, specializing in radiology.

In operation since 2021.

What is accompanied by

The feeling of “fog in the head” is accompanied by other asthenic phenomena, the most common of which are the following:

Feeling of general fatigue and malaise.
Poor attention, difficulty learning and mastering new material.
Altered perception: derealization and depersonalization.
Thoroughness, getting stuck on little things.
Feeling of unclear thinking, stupefaction and “stupidity”.
Slowing down the flow of thoughts.
Uncertainty in movements.

In addition, “fog in the head” is often accompanied by so-called psychosomatic symptoms: waves of heat or cold throughout the body, numbness or discomfort in different parts of the body, palpitations and shortness of breath, trembling, weakness, etc.

Associated symptoms

The feeling of “fog in the head” may be accompanied by other complaints and symptoms, which you can read about by clicking on the appropriate links:

confusion in thoughts
lack of emotions and feelings
heaviness throughout the body
chronic fatigue
emotional instability
increased tearfulness
lump in the throat
breakdown
poor concentration
difficulty making decisions
need to double check
burning sensation in the head
feeling of internal change.

Which specialist should I contact?

If you have complaints about “fog in the head,” you should consult a neurologist or psychiatrist. If they are absent, see a doctor of any specialty.

How to get rid

In order to get rid of such an unpleasant symptom, you need to find out the cause. To do this, we recommend that you consult a doctor. The doctor will determine what the triggering factor was and what mechanisms in the body’s functioning were disrupted. Usually, one consultation with an experienced doctor is enough to clarify the causes of such a disorder. But in some cases, examinations in the form of analyses, tests, and hardware studies may be required.

If it turns out that the cause is overwork, then proper rest and isolation from external stimuli for a short time will completely eliminate all complaints. In such cases, doctors make a conclusion: Asthenic (astheno-neurotic) syndrome.

If the feeling of “foggy head” is a consequence of any disease, then treatment will be required. In this case, a diagnosis of the underlying disease that caused this complaint will be made.

We conducted an analysis over 10 years (from 2010 to 2021) of patients who came to our clinic with complaints of “fog in the head.” In about a third of cases, the cause of this symptom was overwork, and in 60-70% diseases were identified that caused this unpleasant feeling and required treatment.

Brain fog

Many patients with hypothyroidism continue to experience symptoms despite taking thyroid hormone replacement therapy and having normal thyroid function test results. These symptoms may include quantifiable cognitive impairment, quality of life disturbances, and metabolic disturbances. However, some patients also experience vague and difficult-to-quantify symptoms that they describe as brain fog. The brain fog phenomenon has been described with slightly different characteristics in several different chronic conditions, including postural orthostatic tachycardia syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, postmenopausal syndrome, and recently among patients with long-term persistent symptoms of COVID-19.

Materials and methods

Brain fog associated with treated hypothyroidism has not previously been studied in detail despite the fact that patients often report characteristic clinical symptoms. The survey results were presented May 29 at the virtual American Association of Clinical Endocrinology (AACE) 2021 Annual Meeting. The results come from a survey of more than 700 patients with hypothyroidism due to thyroid surgery and/or radioactive iodine (RAI) therapy or autoimmune thyroiditis Hashimoto's who reported symptoms of brain fog. An online survey was conducted with the help of hypothyroidism support groups and the American Thyroid Association.

results

Of the 5,282 respondents with hypothyroidism and brain fog symptoms, 46% (2,453) reported experiencing brain fog symptoms before being diagnosed with hypothyroidism.
Of the population analyzed, 17% (731) of patients reported experiencing symptoms of brain fog several weeks to several months after their hypothyroidism diagnosis.
Of these, 33% had a history of Hashimoto's thyroiditis, 21% had undergone thyroid surgery, 11% had received RAI therapy, and 15.6% had both thyroid surgery and RAI.
Brain fog symptoms were observed “often” in 44.5% and “all the time” in 37.0%.
The total symptom score was 22.9 out of 30.
Fatigue or lack of energy was the most commonly reported symptom, reported by more than 90% of participants in both the thyroid surgery/RAI and Hashimoto's thyroiditis groups, and occurred "all the time" in about half in each group.
At least half of both groups reported other memory problems, difficulty concentrating, sleep disturbances and difficulty making decisions.
Other commonly reported symptoms included confusion, decreased mood, and anxiety.
The survey asked patients what factors improved or worsened brain fog symptoms. By far the most common response was rest/relaxation, endorsed by 58.5%.
Another 10.5% indicated that exercise/time outdoors, but 1.5% in contrast noted that exercise worsened their symptoms.
Unspecified changes in thyroid medication were said to improve symptoms in 13.9%.
Specific thyroid hormones reported to improve symptoms were liothyronine in 8.8%, desiccated thyroid extract in 3.1%, and levothyroxine in 2.7%.
4.2% noted a deterioration in their health while taking thyroxine.
A healthy/nutritious diet was reported to improve symptoms in 6.3%, while gluten consumption, a high-sugar diet, and alcohol consumption worsened symptoms in 1.3%, 3.2%, and 1.3%, respectively.
Caffeine improved the condition in 3.1% and worsened it in 0.6%.
A small number of patients reported improvement in symptoms with vitamins B12 and D, stimulant medications, antidepressants, naltrexone, sun exposure, and blood glucose stability.
Other factors that worsened symptoms included menstruation, infection or other acute illness, pain, and “loud noise.”

Conclusion

A new study suggests that the phenomenon of brain fog reported by some patients with hypothyroidism, despite adequate treatment, is often associated with fatigue and cognitive symptoms, and this condition can be alleviated using a variety of pharmacological and non-pharmacological approaches. The most significant symptom for brain fog reported in the study was general fatigue, followed by forgetfulness and difficulty concentrating. On the other hand, rest and relaxation were the most commonly reported symptom relievers, followed only by adjustment of thyroid hormone profile.

Source:

medscape.com/viewarticle/952630#vp_1