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Clouding of consciousness

January 01, 1970

"Brain fog" redirects here. Not to be confused with Brain fag or Mild cognitive impairment.

Clouding of consciousness, also called brain fog or mental fog,[1][2] occurs when a person is slightly less wakeful or aware than normal.[3] They are less aware of time and their surroundings, and find it difficult to pay attention.[3] People describe this subjective sensation as their mind being "foggy".[4]

Background edit

The term clouding of consciousness has always denoted the main pathogenetic feature of delirium since physician Georg Greiner[5] pioneered the term (Verdunkelung des Bewusstseins) in 1817.[6] The Diagnostic and Statistical Manual of Mental Disorders (DSM) has historically used the term in its definition of delirium.[7] The DSM-III-R and the DSM-IV replaced "clouding of consciousness" with "disturbance of consciousness" to make it easier to operationalize, but it is still fundamentally the same thing.[8] Clouding of consciousness may be less severe than delirium on a spectrum of abnormal consciousness.[3][9][10] Clouding of consciousness may be synonymous with subsyndromal delirium.[11]

Subsyndromal delirium differs from normal delirium by being overall less severe, lacking acuteness in onset and duration, having a relatively stable sleep-wake cycle, and having relatively stable motor alterations.[12] Subsyndromal delirium's significant clinical features are inattention, thought process abnormalities, comprehension abnormalities, and language abnormalities.[12] Delirium's full clinical manifestations may never be reached.[11] Among intensive care unit patients, subsyndromal subjects were as likely to survive as patients with a Delirium Screening Checklist score of 0, but required extended care at rates greater than 0-scoring patients (although lower rates than those with full delirium)[11] or have a decreased post-discharge level of functional independence vs. the general population but still more independence than full delirium.[12]

In clinical practice, no standard test is exclusive and specific; therefore, the diagnosis depends on the physician's subjective impression. The DSM-IV-TR instructs clinicians to code subsyndromal delirium presentations under the miscellaneous category "cognitive disorder not otherwise specified".[13]

Psychopathology edit

The conceptual model of clouding of consciousness is that of a part of the brain regulating the "overall level" of consciousness, which is responsible for awareness of oneself and of the environment.[3][14] Various etiologies disturb this regulating part of the brain, which in turn disturbs the "overall level" of consciousness.[15] This system of a sort of general activation of consciousness is called "arousal" or "wakefulness".[14]

It is not necessarily accompanied by drowsiness.[16] Patients may be awake (not sleepy) yet still have a clouded consciousness (disorder of wakefulness).[17] Paradoxically, affected individuals say that they are "awake but, in another way, not".[18] Lipowski points out that decreased "wakefulness" as used here is not exactly synonymous with drowsiness. One is a stage on the way to coma, the other on the way to sleep, which is very different.[19][20]

The affected person has a sensation of mental clouding described in the patient's own words as "foggy".[4] One patient said, "I thought it became like misty, in some way... the outlines were sort of fuzzy".[18] Others may describe a "spaced-out" feeling.[21] Affected people compare their overall experience to that of a dream, because, as in a dream, consciousness, attention, orientation to time and place, perceptions, and awareness are disturbed.[22] Barbara Schildkrout, a clinical instructor in psychiatry at the Harvard Medical School, described her subjective experience of clouding of consciousness, which she also called "mental fog", after taking a single dose of chlorpheniramine (an antihistamine for her allergy to cottonwood) on a cross-country road trip. She described feeling "out of it" and being in a "dreamy state". She described a sense of not trusting her own judgment and a dulled awareness, not knowing how much time had passed.[1] Clouding of consciousness is not the same thing as depersonalization, though people affected by both compare their experience to that of a dream. Psychometric tests produce little evidence of a relationship between clouding of consciousness and depersonalization.[23]

Brain fog may affect performance on virtually any cognitive task.[1] As one author put it, "It should be apparent that cognition is not possible without a reasonable degree of arousal."[3] Cognition includes perception, memory, learning, executive functions, language, constructive abilities, voluntary motor control, attention, and mental speed. Brain fog's most significant clinical features are inattention, thought process abnormalities, comprehension abnormalities, and language abnormalities.[12] The extent of the impairment is variable because inattention may impair several cognitive functions. Affected people may complain of forgetfulness, being "confused",[24] or being "unable to think straight".[24] Despite the similarities, subsyndromal delirium is not the same thing as mild cognitive impairment; the fundamental difference is that mild cognitive impairment is a dementia-like impairment, which does not involve a disturbance in arousal (wakefulness).[25]

In diseases edit

The term "brain fog" is used to represent a subjective condition of perceived cognitive impairment. It is defined as "a phenomenon of fluctuating states of perceived cognitive dysfunction that could have implications in the functional application of cognitive skills in people's participation in daily activities".[26] Brain fog is a common symptom in many illnesses where chronic pain is a major component.[26] Brain fog affects 15% to 40% of those with chronic pain as their major illness.[27] In such illnesses, pain processing may use up resources, decreasing the brain's ability to think effectively.[26]

Many people with fibromyalgia experience cognitive problems[28] (known as "fibrofog" or "brainfog"), which may involve impaired concentration,[29][30][unreliable medical source?][31] problems with short[32]- and long-term memory, short-term memory consolidation,[32] working memory,[33] impaired speed of performance,[32] inability to multitask, cognitive overload,[32] and diminished attention span. About 75% of fibromyalgia patients report significant problems with concentration, memory, and multitasking.[34] A 2018 meta-analysis found that the largest differences between fibromyalgia patients and healthy subjects were for inhibitory control, memory, and processing speed.[34] Many of these are also common symptoms of ADHD (attention deficit hyperactivity disorder), and studies have linked the two conditions, to the point that a fibromyalgia diagnosis has been proposed as an indication to screen for ADHD.[35][36][37] It is alternatively hypothesized that the increased pain compromises attention systems, resulting in cognitive problems.[34]

In chronic fatigue syndrome, also known as myalgic encephalomyelitis, the CDC's recommended criteria for diagnosis[38] include that one of the following symptoms must be present:[38]

  • Problems with thinking and memory (cognitive dysfunction, sometimes described as "brain fog")
  • While standing or sitting upright, lightheadedness, dizziness, weakness, fainting, or vision changes may occur (orthostatic intolerance)

Lyme disease's neurologic syndrome, called Lyme encephalopathy, is associated with subtle memory and cognitive difficulties, among other issues.[39] Lyme can cause a chronic encephalomyelitis that resembles multiple sclerosis. It may be progressive and can involve cognitive impairment, migraines, balance problems, and other symptoms.[citation needed]

The emerging concept of sluggish cognitive tempo has also been implicated in the expression of brain fog symptoms.[40]

Patients recovering from COVID-19 report experiencing brain fog, which can reflect a wide variety of neurological and psychological symptoms linked to COVID-19.[41]

Brain fog and other neurological symptoms may also result from mold exposure.[42][43][44][45][46] This may be due to mycotoxin exposure and consequent innate immune system activation and inflammation, including in the central nervous system.[47][42][43][44][45][46] But adverse neurological health effects of mold exposure are controversial due to inadequate research and data, and more research is needed in this area.[47][48][49][42][44][46]

See also edit

References edit

  1. ^ a b c Schildkrout, Barbara (2011). Unmasking Psychological Symptoms. John Wiley & Sons. pp. 183–184. ISBN 978-0470639078.
  2. ^ Basavanna, M. (2000). Dictionary of Psychology. Allied Publishers. p. 65. ISBN 8177640305.
  3. ^ a b c d e Plum and Posner's diagnosis of stupor and coma. Oxford University Press. 2007. pp. 5–6. ISBN 978-0199886531.
  4. ^ a b Augusto Caraceni; Luigi Grassi (2011). Delirium: Acute Confusional States in Palliative Medicine. Oxford University Press. p. 82. ISBN 978-0199572052.
  5. ^ Georg Friedrich Christoph Greiner (1817). Der Traum und das fieberhafte Irreseyn: ein physiologisch-psychologischer Versuch. F. A Brockhaus. OCLC 695736431.
  6. ^ Augusto Caraceni; Luigi Grassi (2011). Delirium: Acute Confusional States in Palliative Medicine. Oxford University Press. p. 2. ISBN 978-0199572052.
  7. ^ George Stein; Greg Wilkinson (2007). Seminars in General Adult Psychiatry. RCPsych Publications. p. 490. ISBN 978-1904671442.
  8. ^ Dan G. Blazer; Adrienne O. van Nieuwenhuizen (2012). "Evidence for the Diagnostic Criteria of Delirium". Curr Opin Psychiatry. 25 (3): 239–243. doi:10.1097/yco.0b013e3283523ce8. PMID 22449764. S2CID 39516431.
  9. ^ Anthony David; Simon Fleminger; Michael Kopelman; Simon Lovestone; John Mellers (April 2012). Lishman's Organic Psychiatry: A Textbook of Neuropsychiatry. John Wiley & Sons. p. 5. ISBN 978-0470675076.
  10. ^ Fang Gao Smith (2010). Core Topics in Critical Care Medicine. Cambridge University Press. p. 312. ISBN 978-1139489683.
  11. ^ a b c Sébastien Ouimet; Riker, R; Bergeron, N; Cossette, M; Kavanagh, B; Skrobik, Y; et al. (2007). "Subsyndromal delirium in the ICU: evidence for a disease spectrum". Intensive Care Med. 33 (6): 1007–1013. doi:10.1007/s00134-007-0618-y. PMID 17404704. S2CID 20565946.
  12. ^ a b c d David Meagher; Adamis, D.; Trzepacz, P.; Leonard, M.; et al. (2012). "Features of subsyndromal and persistent delirium". The British Journal of Psychiatry. 200 (1): 37–44. doi:10.1192/bjp.bp.111.095273. PMID 22075650.
  13. ^ Augusto Caraceni; Luigi Grassi (2011). Delirium: Acute Confusional States in Palliative Medicine. Oxford University Press. p. 11. ISBN 978-0199572052.
  14. ^ a b Augusto Caraceni; Luigi Grassi (2011). Delirium: Acute Confusional States in Palliative Medicine. Oxford University Press. pp. 19–21. ISBN 978-0199572052.
  15. ^ Yudofsky & Hales (2008). The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences. American Psychiatric Pub. p. 477. ISBN 978-1585622399.
  16. ^ Roger A. MacKinnon; Robert Michels; Peter J. Buckley (2006). The Psychiatric Interview in Clinical Practice (2nd ed.). American Psychiatric Publishing, Inc. pp. 462–464.
  17. ^ Plum and Posner's diagnosis of stupor and coma. Oxford University Press. 2007. p. 8. ISBN 978-0198043362.
  18. ^ a b G Sorensen Duppils; K Wikblad (May 2007). "Patients' experiences of being delirious". Journal of Clinical Nursing. 16 (5): 810–818. doi:10.1111/j.1365-2702.2006.01806.x. PMID 17462032.
  19. ^ Lipowski ZJ. (1967). "Delirium, clouding of consciousness and confusion". Journal of Nervous and Mental Disease. 145 (3): 227–255. doi:10.1097/00005053-196709000-00006. PMID 4863989.
  20. ^ William Alwyn Lishman (1998). Organic Psychiatry: The Psychological Consequences of Cerebral Disorder. John Wiley & Sons. p. 4.
  21. ^ Fred Ovsiew, M.D. (1999). Neuropsychiatry and Mental Health Services. American Psychiatric Press, Inc. p. 170. ISBN 0880487305.
  22. ^ Simon Fleminger (2002). "Remembering delirium". The British Journal of Psychiatry. 180 (1): 4–5. doi:10.1192/bjp.180.1.4. PMID 11772842.
  23. ^ Sedman, G. (July 1970). "Theories of Depersonalization: A Re-appraisal". British Journal of Psychiatry. 117 (536): 1–14. doi:10.1192/s0007125000192104. PMID 4920886. S2CID 246610704.
  24. ^ a b John Noble; Harry L. Greene (1996). Textbook of Primary Care Medicine. Mosby. p. 1325.
  25. ^ Plum and Posner's diagnosis of stupor and coma. Oxford University Press. 2007. p. 7. ISBN 978-0199886531.
  26. ^ a b c Dass, Ronessa; Kalia, Mohini; Harris, Jocelyn; Packham, Tara (2023-12-31). "Understanding the Experience and Impacts of Brain Fog in Chronic Pain: A Scoping Review". Canadian Journal of Pain. 7 (1). doi:10.1080/24740527.2023.2217865. ISSN 2474-0527. PMC 10334862. PMID 37441085.
  27. ^ Kucyi, Aaron; Davis, Karen D. (2015). "The dynamic pain connectome". Trends in Neurosciences. 38 (2): 86–95. doi:10.1016/j.tins.2014.11.006. PMID 25541287. S2CID 745129.
  28. ^ Glass, Jennifer M. (November 2006). "Cognitive dysfunction in fibromyalgia and chronic fatigue syndrome: New trends and future directions". Current Rheumatology Reports. 8 (6): 425–429. doi:10.1007/s11926-006-0036-0. PMID 17092441. S2CID 27103590.
  29. ^ Arnold, Lesley M.; Bennett, Robert M.; Crofford, Leslie J.; Dean, Linda E.; Clauw, Daniel J.; Goldenberg, Don L.; Fitzcharles, Mary-Ann; Paiva, Eduardo S.; Staud, Roland; Sarzi-Puttini, Piercarlo; Buskila, Dan; Macfarlane, Gary J. (June 2019). "AAPT Diagnostic Criteria for Fibromyalgia". The Journal of Pain. 20 (6): 611–628. doi:10.1016/j.jpain.2018.10.008. hdl:2434/632765. PMID 30453109. S2CID 53872511.
  30. ^ Williams, David A; Clauw, Daniel J; Glass, Jennifer M (April 2011). "Perceived Cognitive Dysfunction in Fibromyalgia Syndrome". Journal of Musculoskeletal Pain. 19 (2): 66–75. doi:10.3109/10582452.2011.558989. S2CID 144893303.
  31. ^ [unreliable medical source?] Leavitt, Frank; Katz, Robert S.; Mills, Megan; Heard, Amy R. (April 2002). "Cognitive and Dissociative Manifestations in Fibromyalgia". JCR: Journal of Clinical Rheumatology. 8 (2): 77–84. doi:10.1097/00124743-200204000-00003. PMID 17041327. S2CID 12352666.
  32. ^ a b c d Buskila, Dan; Cohen, Hagit (October 2007). "Comorbidity of fibromyalgia and psychiatric disorders". Current Pain and Headache Reports. 11 (5): 333–338. doi:10.1007/s11916-007-0214-4. PMID 17894922. S2CID 28038437.
  33. ^ Mercado, Francisco; Ferrera, David; Fernandes-Magalhaes, Roberto; Peláez, Irene; Barjola, Paloma (2 March 2022). "Altered Subprocesses of Working Memory in Patients with Fibromyalgia: An Event-Related Potential Study Using N -Back Task". Pain Medicine. 23 (3): 475–487. doi:10.1093/pm/pnab190. PMID 34145889.
  34. ^ a b c Bell, Tyler; Trost, Zina; Buelow, Melissa T.; Clay, Olivio; Younger, Jarred; Moore, David; Crowe, Michael (9 August 2018). "Meta-analysis of cognitive performance in fibromyalgia". Journal of Clinical and Experimental Neuropsychology. 40 (7): 698–714. doi:10.1080/13803395.2017.1422699. PMC 6151134. PMID 29388512.
  35. ^ Bou Khalil, Rami; Khoury, Elie; Richa, Sami (1 September 2018). "The Comorbidity of Fibromyalgia Syndrome and Attention Deficit and Hyperactivity Disorder from a Pathogenic Perspective". Pain Medicine. 19 (9): 1705–1709. doi:10.1093/pm/pny142. PMID 30053155.
  36. ^ Yilmaz, Ertan; Tamam, Lut (24 July 2018). "Attention-deficit hyperactivity disorder and impulsivity in female patients with fibromyalgia". Neuropsychiatric Disease and Treatment. 14: 1883–1889. doi:10.2147/NDT.S159312. PMC 6063452. PMID 30100723.
  37. ^ "Study Suggests Screening Patients with Fibromyalgia Syndrome for ADHD". 28 December 2017.
  38. ^ a b "Symptoms of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". CDC. 9 February 2021.
  39. ^ Bratton, Robert L.; Whiteside, John W.; Hovan, Michael J.; Engle, Richard L.; Edwards, Frederick D. (May 2008). "Diagnosis and Treatment of Lyme Disease". Mayo Clinic Proceedings. 83 (5): 566–571. doi:10.4065/83.5.566. PMID 18452688.
  40. ^ Barkley, Russell A. (2013). Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. Guilford Publications. p. 150. ISBN 978-1-4625-0789-4.
  41. ^ Koralnik, Igor J.; Tyler, Kenneth L. (July 2020). "COVID-19: A Global Threat to the Nervous System". Annals of Neurology. 88 (1): 1–11. doi:10.1002/ana.25807. PMC 7300753. PMID 32506549.
  42. ^ a b c Empting LD (2009). "Neurologic and neuropsychiatric syndrome features of mold and mycotoxin exposure". Toxicol Ind Health. 25 (9–10): 577–581. Bibcode:2009ToxIH..25..577E. doi:10.1177/0748233709348393. PMID 19854819. S2CID 27769836.
  43. ^ a b Valtonen V (2017). "Clinical Diagnosis of the Dampness and Mold Hypersensitivity Syndrome: Review of the Literature and Suggested Diagnostic Criteria". Front Immunol. 8: 951. doi:10.3389/fimmu.2017.00951. PMC 5554125. PMID 28848553.
  44. ^ a b c Harding CF, Liao D, Persaud R, DeStefano RA, Page KG, Stalbow LL, Roa T, Ford JC, Goman KD, Pytte CL (March 2023). "Differential effects of exposure to toxic or nontoxic mold spores on brain inflammation and Morris water maze performance". Behav Brain Res. 442: 114294. doi:10.1016/j.bbr.2023.114294. PMC 10460635. PMID 36638914.
  45. ^ a b Ratnaseelan AM, Tsilioni I, Theoharides TC (June 2018). "Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes". Clin Ther. 40 (6): 903–917. doi:10.1016/j.clinthera.2018.05.004. PMID 29880330.
  46. ^ a b c Harding CF, Pytte CL, Page KG, Ryberg KJ, Normand E, Remigio GJ, DeStefano RA, Morris DB, Voronina J, Lopez A, Stalbow LA, Williams EP, Abreu N (July 2020). "Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction". Brain Behav Immun. 87: 218–228. doi:10.1016/j.bbi.2019.11.006. PMC 7231651. PMID 31751617.
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  49. ^ Borchers AT, Chang C, Eric Gershwin M (June 2017). "Mold and Human Health: a Reality Check". Clin Rev Allergy Immunol. 52 (3): 305–322. doi:10.1007/s12016-017-8601-z. PMID 28299723. S2CID 25709697.

January 01, 1970
clouding, consciousness, brain, redirects, here, confused, with, brain, mild, cognitive, impairment, also, called, brain, mental, occurs, when, person, slightly, less, wakeful, aware, than, normal, they, less, aware, time, their, surroundings, find, difficult,. Brain fog redirects here Not to be confused with Brain fag or Mild cognitive impairment Clouding of consciousness also called brain fog or mental fog 1 2 occurs when a person is slightly less wakeful or aware than normal 3 They are less aware of time and their surroundings and find it difficult to pay attention 3 People describe this subjective sensation as their mind being foggy 4 Contents 1 Background 2 Psychopathology 3 In diseases 4 See also 5 ReferencesBackground editThe term clouding of consciousness has always denoted the main pathogenetic feature of delirium since physician Georg Greiner 5 pioneered the term Verdunkelung des Bewusstseins in 1817 6 The Diagnostic and Statistical Manual of Mental Disorders DSM has historically used the term in its definition of delirium 7 The DSM III R and the DSM IV replaced clouding of consciousness with disturbance of consciousness to make it easier to operationalize but it is still fundamentally the same thing 8 Clouding of consciousness may be less severe than delirium on a spectrum of abnormal consciousness 3 9 10 Clouding of consciousness may be synonymous with subsyndromal delirium 11 Subsyndromal delirium differs from normal delirium by being overall less severe lacking acuteness in onset and duration having a relatively stable sleep wake cycle and having relatively stable motor alterations 12 Subsyndromal delirium s significant clinical features are inattention thought process abnormalities comprehension abnormalities and language abnormalities 12 Delirium s full clinical manifestations may never be reached 11 Among intensive care unit patients subsyndromal subjects were as likely to survive as patients with a Delirium Screening Checklist score of 0 but required extended care at rates greater than 0 scoring patients although lower rates than those with full delirium 11 or have a decreased post discharge level of functional independence vs the general population but still more independence than full delirium 12 In clinical practice no standard test is exclusive and specific therefore the diagnosis depends on the physician s subjective impression The DSM IV TR instructs clinicians to code subsyndromal delirium presentations under the miscellaneous category cognitive disorder not otherwise specified 13 Psychopathology editThe conceptual model of clouding of consciousness is that of a part of the brain regulating the overall level of consciousness which is responsible for awareness of oneself and of the environment 3 14 Various etiologies disturb this regulating part of the brain which in turn disturbs the overall level of consciousness 15 This system of a sort of general activation of consciousness is called arousal or wakefulness 14 It is not necessarily accompanied by drowsiness 16 Patients may be awake not sleepy yet still have a clouded consciousness disorder of wakefulness 17 Paradoxically affected individuals say that they are awake but in another way not 18 Lipowski points out that decreased wakefulness as used here is not exactly synonymous with drowsiness One is a stage on the way to coma the other on the way to sleep which is very different 19 20 The affected person has a sensation of mental clouding described in the patient s own words as foggy 4 One patient said I thought it became like misty in some way the outlines were sort of fuzzy 18 Others may describe a spaced out feeling 21 Affected people compare their overall experience to that of a dream because as in a dream consciousness attention orientation to time and place perceptions and awareness are disturbed 22 Barbara Schildkrout a clinical instructor in psychiatry at the Harvard Medical School described her subjective experience of clouding of consciousness which she also called mental fog after taking a single dose of chlorpheniramine an antihistamine for her allergy to cottonwood on a cross country road trip She described feeling out of it and being in a dreamy state She described a sense of not trusting her own judgment and a dulled awareness not knowing how much time had passed 1 Clouding of consciousness is not the same thing as depersonalization though people affected by both compare their experience to that of a dream Psychometric tests produce little evidence of a relationship between clouding of consciousness and depersonalization 23 Brain fog may affect performance on virtually any cognitive task 1 As one author put it It should be apparent that cognition is not possible without a reasonable degree of arousal 3 Cognition includes perception memory learning executive functions language constructive abilities voluntary motor control attention and mental speed Brain fog s most significant clinical features are inattention thought process abnormalities comprehension abnormalities and language abnormalities 12 The extent of the impairment is variable because inattention may impair several cognitive functions Affected people may complain of forgetfulness being confused 24 or being unable to think straight 24 Despite the similarities subsyndromal delirium is not the same thing as mild cognitive impairment the fundamental difference is that mild cognitive impairment is a dementia like impairment which does not involve a disturbance in arousal wakefulness 25 In diseases editThe term brain fog is used to represent a subjective condition of perceived cognitive impairment It is defined as a phenomenon of fluctuating states of perceived cognitive dysfunction that could have implications in the functional application of cognitive skills in people s participation in daily activities 26 Brain fog is a common symptom in many illnesses where chronic pain is a major component 26 Brain fog affects 15 to 40 of those with chronic pain as their major illness 27 In such illnesses pain processing may use up resources decreasing the brain s ability to think effectively 26 Many people with fibromyalgia experience cognitive problems 28 known as fibrofog or brainfog which may involve impaired concentration 29 30 unreliable medical source 31 problems with short 32 and long term memory short term memory consolidation 32 working memory 33 impaired speed of performance 32 inability to multitask cognitive overload 32 and diminished attention span About 75 of fibromyalgia patients report significant problems with concentration memory and multitasking 34 A 2018 meta analysis found that the largest differences between fibromyalgia patients and healthy subjects were for inhibitory control memory and processing speed 34 Many of these are also common symptoms of ADHD attention deficit hyperactivity disorder and studies have linked the two conditions to the point that a fibromyalgia diagnosis has been proposed as an indication to screen for ADHD 35 36 37 It is alternatively hypothesized that the increased pain compromises attention systems resulting in cognitive problems 34 In chronic fatigue syndrome also known as myalgic encephalomyelitis the CDC s recommended criteria for diagnosis 38 include that one of the following symptoms must be present 38 Problems with thinking and memory cognitive dysfunction sometimes described as brain fog While standing or sitting upright lightheadedness dizziness weakness fainting or vision changes may occur orthostatic intolerance Lyme disease s neurologic syndrome called Lyme encephalopathy is associated with subtle memory and cognitive difficulties among other issues 39 Lyme can cause a chronic encephalomyelitis that resembles multiple sclerosis It may be progressive and can involve cognitive impairment migraines balance problems and other symptoms citation needed The emerging concept of sluggish cognitive tempo has also been implicated in the expression of brain fog symptoms 40 Patients recovering from COVID 19 report experiencing brain fog which can reflect a wide variety of neurological and psychological symptoms linked to COVID 19 41 Brain fog and other neurological symptoms may also result from mold exposure 42 43 44 45 46 This may be due to mycotoxin exposure and consequent innate immune system activation and inflammation including in the central nervous system 47 42 43 44 45 46 But adverse neurological health effects of mold exposure are controversial due to inadequate research and data and more research is needed in this area 47 48 49 42 44 46 See also edit nbsp Psychiatry portal nbsp Psychology portal nbsp Medicine portal Cannabis use disorder Cognitive orthotics Depersonalization derealization disorder Excessive daytime sleepiness Four boxes test Idiopathic hypersomnia Insomnia Mental confusion Mild cognitive impairment Obtundation Postural orthostatic tachycardia syndrome POTS Post chemotherapy cognitive impairment Pumphead syndrome Reactive hypoglycemia Sleep inertia Slow wave sleep Somnolence StuporReferences edit a b c Schildkrout Barbara 2011 Unmasking Psychological Symptoms John Wiley amp Sons pp 183 184 ISBN 978 0470639078 Basavanna M 2000 Dictionary of Psychology Allied Publishers p 65 ISBN 8177640305 a b c d e Plum and Posner s diagnosis of stupor and coma Oxford University Press 2007 pp 5 6 ISBN 978 0199886531 a b Augusto Caraceni Luigi Grassi 2011 Delirium Acute Confusional States in Palliative Medicine Oxford University Press p 82 ISBN 978 0199572052 Georg Friedrich Christoph Greiner 1817 Der Traum und das fieberhafte Irreseyn ein physiologisch psychologischer Versuch F A Brockhaus OCLC 695736431 Augusto Caraceni Luigi Grassi 2011 Delirium Acute Confusional States in Palliative Medicine Oxford University Press p 2 ISBN 978 0199572052 George Stein Greg Wilkinson 2007 Seminars in General Adult Psychiatry RCPsych Publications p 490 ISBN 978 1904671442 Dan G Blazer Adrienne O van Nieuwenhuizen 2012 Evidence for the Diagnostic Criteria of Delirium Curr Opin Psychiatry 25 3 239 243 doi 10 1097 yco 0b013e3283523ce8 PMID 22449764 S2CID 39516431 Anthony David Simon Fleminger Michael Kopelman Simon Lovestone John Mellers April 2012 Lishman s Organic Psychiatry A Textbook of Neuropsychiatry John Wiley amp Sons p 5 ISBN 978 0470675076 Fang Gao Smith 2010 Core Topics in Critical Care Medicine Cambridge University Press p 312 ISBN 978 1139489683 a b c Sebastien Ouimet Riker R Bergeron N Cossette M Kavanagh B Skrobik Y et al 2007 Subsyndromal delirium in the ICU evidence for a disease spectrum Intensive Care Med 33 6 1007 1013 doi 10 1007 s00134 007 0618 y PMID 17404704 S2CID 20565946 a b c d David Meagher Adamis D Trzepacz P Leonard M et al 2012 Features of subsyndromal and persistent delirium The British Journal of Psychiatry 200 1 37 44 doi 10 1192 bjp bp 111 095273 PMID 22075650 Augusto Caraceni Luigi Grassi 2011 Delirium Acute Confusional States in Palliative Medicine Oxford University Press p 11 ISBN 978 0199572052 a b Augusto Caraceni Luigi Grassi 2011 Delirium Acute Confusional States in Palliative Medicine Oxford University Press pp 19 21 ISBN 978 0199572052 Yudofsky amp Hales 2008 The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences American Psychiatric Pub p 477 ISBN 978 1585622399 Roger A MacKinnon Robert Michels Peter J Buckley 2006 The Psychiatric Interview in Clinical Practice 2nd ed American Psychiatric Publishing Inc pp 462 464 Plum and Posner s diagnosis of stupor and coma Oxford University Press 2007 p 8 ISBN 978 0198043362 a b G Sorensen Duppils K Wikblad May 2007 Patients experiences of being delirious Journal of Clinical Nursing 16 5 810 818 doi 10 1111 j 1365 2702 2006 01806 x PMID 17462032 Lipowski ZJ 1967 Delirium clouding of consciousness and confusion Journal of Nervous and Mental Disease 145 3 227 255 doi 10 1097 00005053 196709000 00006 PMID 4863989 William Alwyn Lishman 1998 Organic Psychiatry The Psychological Consequences of Cerebral Disorder John Wiley amp Sons p 4 Fred Ovsiew M D 1999 Neuropsychiatry and Mental Health Services American Psychiatric Press Inc p 170 ISBN 0880487305 Simon Fleminger 2002 Remembering delirium The British Journal of 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1007 s11926 006 0036 0 PMID 17092441 S2CID 27103590 Arnold Lesley M Bennett Robert M Crofford Leslie J Dean Linda E Clauw Daniel J Goldenberg Don L Fitzcharles Mary Ann Paiva Eduardo S Staud Roland Sarzi Puttini Piercarlo Buskila Dan Macfarlane Gary J June 2019 AAPT Diagnostic Criteria for Fibromyalgia The Journal of Pain 20 6 611 628 doi 10 1016 j jpain 2018 10 008 hdl 2434 632765 PMID 30453109 S2CID 53872511 Williams David A Clauw Daniel J Glass Jennifer M April 2011 Perceived Cognitive Dysfunction in Fibromyalgia Syndrome Journal of Musculoskeletal Pain 19 2 66 75 doi 10 3109 10582452 2011 558989 S2CID 144893303 unreliable medical source Leavitt Frank Katz Robert S Mills Megan Heard Amy R April 2002 Cognitive and Dissociative Manifestations in Fibromyalgia JCR Journal of Clinical Rheumatology 8 2 77 84 doi 10 1097 00124743 200204000 00003 PMID 17041327 S2CID 12352666 a b c d Buskila Dan Cohen Hagit October 2007 Comorbidity of fibromyalgia and psychiatric disorders Current Pain and Headache Reports 11 5 333 338 doi 10 1007 s11916 007 0214 4 PMID 17894922 S2CID 28038437 Mercado Francisco Ferrera David Fernandes Magalhaes Roberto Pelaez Irene Barjola Paloma 2 March 2022 Altered Subprocesses of Working Memory in Patients with Fibromyalgia An Event Related Potential Study Using N Back Task Pain Medicine 23 3 475 487 doi 10 1093 pm pnab190 PMID 34145889 a b c Bell Tyler Trost Zina Buelow Melissa T Clay Olivio Younger Jarred Moore David Crowe Michael 9 August 2018 Meta analysis of cognitive performance in fibromyalgia Journal of Clinical and Experimental Neuropsychology 40 7 698 714 doi 10 1080 13803395 2017 1422699 PMC 6151134 PMID 29388512 Bou Khalil Rami Khoury Elie Richa Sami 1 September 2018 The Comorbidity of Fibromyalgia Syndrome and Attention Deficit and Hyperactivity Disorder from a Pathogenic Perspective Pain Medicine 19 9 1705 1709 doi 10 1093 pm pny142 PMID 30053155 Yilmaz Ertan Tamam Lut 24 July 2018 Attention deficit hyperactivity disorder and impulsivity in female patients with fibromyalgia Neuropsychiatric Disease and Treatment 14 1883 1889 doi 10 2147 NDT S159312 PMC 6063452 PMID 30100723 Study Suggests Screening Patients with Fibromyalgia Syndrome for ADHD 28 December 2017 a b Symptoms of ME CFS Myalgic Encephalomyelitis Chronic Fatigue Syndrome ME CFS CDC 9 February 2021 Bratton Robert L Whiteside John W Hovan Michael J Engle Richard L Edwards Frederick D May 2008 Diagnosis and Treatment of Lyme Disease Mayo Clinic Proceedings 83 5 566 571 doi 10 4065 83 5 566 PMID 18452688 Barkley Russell A 2013 Taking Charge of ADHD The Complete Authoritative Guide for Parents Guilford Publications p 150 ISBN 978 1 4625 0789 4 Koralnik Igor J Tyler Kenneth L July 2020 COVID 19 A Global Threat to the Nervous System Annals of Neurology 88 1 1 11 doi 10 1002 ana 25807 PMC 7300753 PMID 32506549 a b c Empting LD 2009 Neurologic and neuropsychiatric syndrome features of mold and mycotoxin exposure Toxicol Ind Health 25 9 10 577 581 Bibcode 2009ToxIH 25 577E doi 10 1177 0748233709348393 PMID 19854819 S2CID 27769836 a b Valtonen V 2017 Clinical Diagnosis of the Dampness and Mold Hypersensitivity Syndrome Review of the Literature and Suggested Diagnostic Criteria Front Immunol 8 951 doi 10 3389 fimmu 2017 00951 PMC 5554125 PMID 28848553 a b c Harding CF Liao D Persaud R DeStefano RA Page KG Stalbow LL Roa T Ford JC Goman KD Pytte CL March 2023 Differential effects of exposure to toxic or nontoxic mold spores on brain inflammation and Morris water maze performance Behav Brain Res 442 114294 doi 10 1016 j bbr 2023 114294 PMC 10460635 PMID 36638914 a b Ratnaseelan AM Tsilioni I Theoharides TC June 2018 Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes Clin Ther 40 6 903 917 doi 10 1016 j clinthera 2018 05 004 PMID 29880330 a b c Harding CF Pytte CL Page KG Ryberg KJ Normand E Remigio GJ DeStefano RA Morris DB Voronina J Lopez A Stalbow LA Williams EP Abreu N July 2020 Mold inhalation causes innate immune activation neural cognitive and emotional dysfunction Brain Behav Immun 87 218 228 doi 10 1016 j bbi 2019 11 006 PMC 7231651 PMID 31751617 a b Viljoen Margaretha Claassen Nicolaas February 2023 Pathophysiological aspects of exposure to dampness associated indoor mould and mycotoxins A mini overview Journal of Hazardous Materials Advances 9 100228 doi 10 1016 j hazadv 2022 100228 ISSN 2772 4166 Rudert A Portnoy J August 2017 Mold allergy is it real and what do we do about it Expert Rev Clin Immunol 13 8 823 835 doi 10 1080 1744666X 2017 1324298 PMID 28453304 S2CID 4755858 Borchers AT Chang C Eric Gershwin M June 2017 Mold and Human Health a Reality Check Clin Rev Allergy Immunol 52 3 305 322 doi 10 1007 s12016 017 8601 z PMID 28299723 S2CID 25709697 Retrieved from https en wikipedia org w index php title Clouding of consciousness amp oldid 1221277241, wikipedia, wiki, book, books, library,

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