Real Foggy

[gparedes]

Brain Fog that impairs concentration; Discomfort behind my eyes and in my temple area that goes up to meet at the top of my forehead; slightly swollen cheek; tunnel type feel/vision; Muscles in my hands seem not to be jumpy (but also I've been lazy/down lately).  Last night I plunged a bath tub and my arm was shaky afterwards; tension headaches and anxiety. I've had a history of anxiety and *think this is brought on by a different element

Went to a gen. doc. she looked in ears and said I had an ear infec.  She gave me zpac and after 6 days this did not work.   She looked in my ears again and said it still had not cleared up well, so she gave me Ceftin 500mg 10 days.  After 6 days, I went to my ENT; he claimed that my ears/nose looked fine; that often these symptoms can come from allergies and that I should start shots back up

Friday, I felt really lightheaded/ anxious and foggy beyond this world. I went ahead to the hospital to have it all checked

They ran a battle of tests in the ER, blood work, CT, urine test, checked my nose/ears and gave a calm-me-down pill.. My blood work was said to be clean. White blood cells were 8.5 (apparently between 5 and 11 is normal)... CT came back (normal)(would that show slight swelling?).  Doctor said to follow up with my primary care and that there was nothing wrong; my ears looked alright.  He also said I didnt have to keep taking the Ceftin

The ENT thinks it's allergies and as such is going to treat me for that. This is the second third year this has happened to me (around the same time too).  The first year it went away while on antibiotics and the second went away about on it's own.  This year it's been lingering.  Also, last year after this spell about a month later I got positional vertigo for a month.  After that I started the allergy shots

Past habits include nicorette gum, Some Smoking, drinking 3 or 4 drinks per night -but not anymore, I quit when this fog thing happened and will continue not drinking

[Craig Job, MD]

Some thoughts I had while reading your list of symtoms. It certainly sounds by your history and physical findings as of late that your ear, nose, and sinuses are congested. This could be from allergies, or from something called "vasomotor rhinitis", which is a bit more elusive in its causes and treatment. Chronic sinusitis is also a possibility. Typically vasomotor rhinitis can be treated with a nasal steroid much like allergic rhinitis but often requires the addition of a second type of nasal spray. Both vasomotor and chronic sinusitis respond to good nasal hygiene, including nasal saline spray or sinus lavage, dust control in the home, good diet (high in omega 3 fatty acids), exercise, and stress reduction. Allergy shots typically are not very helpful for airborne allergies (dust, pollen, mold spores, etc). I would also address sleep and stress particularly as it relates to your anxiety, as this obviously can make the "brain fog" much worse.

[PlateletGal]

"Allergy shots typically are not very helpful for airborne allergies (dust, pollen, mold spores, etc)."

I discovered that personally ! I've heard about sublingual therapy, but understand that it isn't available in the U.S. yet. I have tried homeopathy for my allergies and was surprised to find out that it does help with my symptoms.

[Kevin Pho, MD]

I agree with the workup thus far, including the antibiotics courses and CT scan.

Allergy testing can be considered, as well as optimizing treatment for chronic rhinitis.  This can include further evaluation with a sinus CT scan, as well as nasal steroid sprays.  

A referral to a neurologist can be considered.  Further imaging with an MRI can be done to exclude pathology in the brain.  If seizures are considered (which can lead to a "fog"), an EEG can be discussed.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.