Permanent Migraine Aura w/ Brain Fog

Male, 18

When I was 14 years old I started having episodes(which did not include headaches) where I would: Lose the center plane of my vision, feel completely disoriented, and completely depersonalized; and would have pins and needles in my extremities and mouth area followed by Numbness and tingling. When I have these episodes they last until I go to sleep. I used to get these episodes about once every 2 months, and they have been happening less and less frequently(haven't had a full blown attack in about a year). However, ever since my first episodes I have been in a permant state of migraine aura which consists of: Seeing falling circles, afterburn on images when I move my eyes, "fireflies" when I look at bright surfaces like white walls and the sky, visual snow which looks like tv static, and worst of all Brain Fog. I have been in the ever worsening brain fog state for 4 years now and I am looking for any solutions. The brain fog feels like severe mental exhaustion, like the kind you get from pulling all nighters, only it's like that all the time starting from the moment I wake up. The brain fog has gotten so bad that I am completely spaced out all the time and not able to study. I have trouble keeping up in conversations and learning new things, or performing anything that takes any amount of thinking. I was very bright before all of this.
I have been in and out of Neurology clinics for the past 4 years and every one seems to agree that it is Migraine Aura but they all say that it shouldn't last this long. So far no one has been able to provide me with a solution.
I have had MRI, EEG, EKG, and all sorts of other tests all of which have come back clean. I have been prescribed: Gabapentin, Maxalt, Celexa, Adderall (adderrall), and Verapil, none of which helped and I am currently not on any medications.

Please I'm in desperate need of help as this keeps getting worse and worse. It has made my life very difficult and taken all the joy out of living.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

The aura of migraine does not continuously occur for 4 years, so while your visual symptoms seem to resemble your migraine phenomena, migraine seems to be an unlikely explanation. Some causes of visual phenomena such as yours include seizures, but if you had these visual changes while you were having an EEG, this is unlikely. In the setting of a normal MRI of the brain, a structural cause (such as tumor, MS etc) are also unlikely, so causes such as primary opthalmologic disorders (eye problems rather than brain problems), medication side effects, or psychiatric causes are possibilities.

Regarding what you term brain fog, this mental exhaustion,  spaced out, lack of concentration also what sounds like for 4 years continuously, there are some potential considerations, that would not necessarily explain your visual symptoms. Sleep disorders, such as sleep apnea, can cause symptoms similar to yours: daytime sleepiness, fatigue, lack of concentration. While sleep apnea typically occurs in overweight people who snore,  it can occur in almost anyone. If you suffer from unrefreshing sleep and have daytime fatigue, one way to exlude a sleep disorder is through a study called polysomnogram (a sleep study). Other potential causes include thyroid disorders, anemia, certain vitamin deficiencies (such as vitamin B12) and depression. Depression can cause lack of concentration, mental exhaustion, and overall sense of lack of well being.

Continued followup with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[MatthewY]

Thanks for the input, I appreciate it. I'm pretty sure that I have been checked for all those things listed above except for the sleep study, but I will ask about them when I go in for my next visit. I was beginning to wonder why I was being diagnosed with a condition when it seems that I do not meet an essential criterion( The amount of time which it has lasted). I think that it is becoming increasingly apparent that while I do have migraines they are not the root cause of this. The only thing that is difficult to explain away is the exact correlation between having a migraine with aura episode and the worsening of my overall condition(brain fog and visual obstructions). So maybe they aggrivate my overall condition but are not the condition itself. I have been to an opthomalogist and they said my eyes were healthy. Also depression is a very convenient scape goat for my condition because it is a very hard diagnosis to disprove, however, I just don't think it makes a whole lot of sense for a couple reasons. 1 For this to effect me 24/7 365 days a year, without a single moment of reprieve EVER I would need to be depressed all the time without a single moment of contentment. Despite my condition there is nothing depressing about my life. There are times when I become preoccupied with something to the point where I'm not thinking about my symptoms but that doesn't make them go away.  2 I was very happy and fulfilled before this all started so to say that depression causes my symptoms I think would be looking at it in reverse. Rather my symptoms are responsible for my depression 3 My symptoms (permanent brain for and visual dilemma) are made worse by intense physical exercise like running. Which from what I understand would be the opposite of how depression would behave. In spite of this I am very physical fit and athletic I go to the gym often but have learned to take it slow and operate within my constraints. Reading also makes my symptoms worse, in fact anything that takes any mental effort at all makes things worse.
Thanks again for the help I'm going to look into your suggestions at my next neuro visit especially the sleep study. If you read this and have any other insight I would love to hear it.

[Tom92W]

I too suffer from similar symptoms as you. MRI ascheduled within the next few weeks. I have siffered from a young age, 13 i think, and in the last few months, hte aura has been constant in my right eye along with a lingering headache in the same area. Beta blockers are providing some relief, but unfortunately, the condition has brought with it anxiety, which has led to tremours and dread. I too find it challenging to concentrate in college ( Vital A level year) but i find not thiking about it is the most effective remedy.

[krayon]

Same here, everything all the same, check my posts, any luck with the sleep tests? It's been 16 years for me, only klonopin 3mg a day helps, but it's all still there, let me know :)