Brain Fog

Many lupus patients describe the phenomenon “brain fog, #lupus fog” when speaking about nervous system complications of their disease. They describe a sensation that “their brains feel fuzzy or not clear.”  70-80% of patients with Fibromyalgia and approximately 20-50% of patients with lupus report experiencing mental fogginess.

These patients may report :

  • Feeling confused
  • Forgetfulness
  • Headaches
  • Extreme mental and general fatigue
  • Poor concentration
  • Inability to focus 
  • Increase irritability 
  • Depression
  • Difficulty with processing information nor learning new things. 

There is a hypothesis to suggest that neurons (brain cells) can be affected by autoantibodies in lupus causing neurocognitive dysfunction.

In lupus “cognitive dysfunction and cognitive impairment can be so debilitating.  

In the office, I see these individuals have a difficult time recalling simple things like medication and names, dates, tasks that they are supposed to do or schedules.  They often state that this cognitive fog prevents them from performing their tasks at work, school and even caretaking responsibilities if they are parents or spouses.

It is important to get a neurologist and neuropsychologist involved to assess other neurological conditions like MS.

A cognitive therapist and speech pathologist can be an integral part of the medical team who may recommend techniques and games to improve concentration and help reduce distractions that can interfere with focus.

What to do?

Lupus and FM patients need to focus on getting adequate sleep to prevent disease triggers.  

  • Participate in stress reduction activities. I tell my patients to do daily yoga, and meditation.  
  • Exercise may also help them focus on a task while providing physical benefits.
  • Check medications that can alter mental status.
  • Keep track of the time of day when the brain fog is present to possibly identify triggers.
  • Write down instructions, important dates and details.
  • Make lists
  • Don’t overschedule and perform a single task at a given time.
  • Stick to routines
  • Repeat numbers, names, and important information over and over again.
  • Work the brain muscle by doing puzzles, playing Scrabble and chess.

Sometimes improving the disease activity (with medications) may also improve the cognitive impairment.

A career change may need to be considered if the brain fog is severe. Talk to your employer or school supervisor.

Let your family members and friends know so they can support you and help you cope with the memory problems!