How do you evaluate and manage brain fog in patients with underlying rheumatic disease?
For Brain fog – Most important this is I stress to patients – there are likely MULTIPLE different things contributing to brain fog, so there are MULTIPLE different things we are going to have to work on to improve it. Active inflammation might be contributing, but there is likely several other facto...
I think the question of when to refer for neuropsych testing in the setting of brain fog is complex. Before referring to neuropsych, I always ask myself what I am going to do with the results. Often, testing will come back with multiple domains in the low average range, particularly attention, and t...
Brain fog, although a characteristic symptom in fibromyalgia, is reported commonly by patients with rheumatoid arthritis and every rheumatic disease. It is a descriptive term for mental exhaustion often associated with cognitive disturbances. Its severity tracks with fatigue and pain and the overall...
I think if you have a perimenopausal female and their rheum dz are well controlled, it is reasonable to look at thyroid, vitamin D, OSA home eval, and a full hormone panel. I try to allow fibromyalgia 3- 6 months of sleep hygiene, tracking deep sleep prior to the introduction of FM meds. I tend to t...
Symmetrel helps some people. Modafinil helps many.
Low-dose naltrexone has been shown to treat a lot of different conditions. I have had it work with brain fog secondary to long-haul COVID as well as some autoimmune conditions.
I have had multiple patients like this with other psychiatric symptoms, where I will use IVIG to good success (n=3). Especially COVID long haulers that have changed since having COVID, or lupus, or ITP. Always something to keep in the back pocket - though neurology/rheumatology might need to be on b...