brain fog
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Introduction
not really a true medical term[6]
Etiology
- most common neurological symptom of long COVID-19
- commonly reported 7.6 months after COVID-19
- more common among hospitalized[2]
- underactive thyroid preceding hypothyroidism[2]
- breast implants
- breast cancer therapy
- brain injury[6]
- dementia[6]
- brain infection[6]
Clinical manifestations
- short-term memory loss
- dysphasia
- word-finding difficulty or speech difficulty, communication difficulty
- category fluency 20%
- word-finding difficulty or speech difficulty, communication difficulty
- processing speed 18%
- executive function 16%
- inattention
- confusion
- dissociative phenomena
- feeling that their brain is lost in a maze[6]
- fuzziness or pressure
- fatigue[4]
- feeling sluggish[6]
- symptoms may persist for weeks, months or years after Covid-19 infection[6]
Diagnostic procedures
- formal cognitive testing[6]
Management
- guanfacine: start 1 mg PO QHS, increase to 2 mg QHS after 1 month + N-acetylcysteine 600 mg daily[5]
- cognitive behavioral therapy
- sleep hygiene[6]
- exercise[6]
- minimize stress, prioritize emotional health[6]
- prevention
More general terms
References
- ↑ Walker M Clinicians Struggle to Make Sense of 'Long COVID' - No correlation with clinical severity of illness, and some symptoms may be entirely new. MedPage Today January 29, 2021 https://www.medpagetoday.com/infectiousdisease/covid19/90959
- ↑ 2.0 2.1 2.2 Monaco K Patients With Underactive Thyroid Report Pervasive Brain Fog. Many said they had symptoms well before a hypothyroidism diagnosis. MedPage Today May 30, 2021 https://www.medpagetoday.com/meetingcoverage/aace/92854
Ettleson M, et al Seeing through the fog: characterizing "brain fog" in those treated for hypothyroidism. American Association of Clinical Endocrinology (AACE) 2021. - ↑ George J Brain Fog After COVID-19 May Last Longer Than We Think. Relatively young people wrestle with cognitive dysfunction for months. MedPage Today October 22, 2021 https://www.medpagetoday.com/neurology/generalneurology/95198
Becker JH, Lin JJ, Doernberg M et al Assessment of Cognitive Function in Patients After COVID-19 Infection. JAMA Netw Open. 2021;4(10):e2130645. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785388 - ↑ 4.0 4.1 McWhirter L, Smyth H, Hoeritzauer I et al What is brain fog? J Neurol Neurosurg Psychiatr 2022. Dec 6, https://jnnp.bmj.com/content/early/2022/12/06/jnnp-2022-329683
- ↑ 5.0 5.1 Fesharaki-Zadeh A, Lowe N, Arnsten AFT Clinical experience with the alpha-2A adrenoceptor agonist, guanfacine, & N-acetylcysteine for the treatment of cognitive deficits in "long Covid-19" Neuroimmunology Reports. 2023. 3
- ↑ 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 6.11 6.12 6.13 6.14 Berg S What doctors wish patients knew about long COVID-19 brain fog. American Medical Association. AMA News Wire. Feb 17, 2023 https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-long-covid-19-brain-fog