
O que causa pressão na cabeça e nevoeiro mental?
Revisado por Dr Sarah Jarvis MBE, FRCGPAuthored by Dr Laurence KnottPublicado originalmente 13 Fev 2018
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A poster to one of our forums, Patient 1, has a two-and-a-half-year history of mild pressure in the head and what he describes as 'brain fog'. He experiences a 'constant cloud' over his brain and never has any mental clarity or a clear head. He has a number of other symptoms including poor short-term memory, detachment from reality, sharp pains in the head and noises in the ears. He suffers from anxiety, made worse or caused by the symptoms.
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O que é névoa cerebral?
I know exactly what Patient 1 means by 'brain fog'. It is the first symptom I get when I have gripe and it is most frustrating as it stops me working. Fortunately, it clears up after a few days. I can't imagine what it must be like to have it for two and a half years.
The first approach would be to make sure this was not a secondary dor de cabeça - in other words, a headache with an identifiable cause. Some of these are more serious than others and would include arterite de células gigantes (uma inflamação das artérias que correm ao longo das têmporas), pressão arterial elevada (hipertensão), hemorragia cerebral, brain infections (eg, encefalite), raised pressure in the fluid of the brain (raised intracranial pressure) and, of course, tumores cerebrais.
Causas menos graves (do ponto de vista de perspectiva) incluem carbon monoxide poisoning, taking too many painkillers (dor de cabeça por uso excessivo de medicação), distúrbios das articulações da mandíbula (distúrbios da articulação temporomandibular), problemas dentários e infecções sinusais (sinusite).
Tentativa e erro
Voltar ao conteúdoPatient 1 and other forum readers have offered their own theories, based on their own knowledge and experiences. They have raised the possibility of epilepsia, glândulas paratireoides hiperativas (hiperparatireoidismo), glândula tireoide hiperativa (tireotoxicose) and disorders of the brain circulation. Patient 2 suggests it could be a deficiência de vitamina B12.
Felizmente, o autor original passou por uma ampla gama de investigações, incluindo tomografias e ressonâncias magnéticas do cérebro, um eletrocardiograma, EEG e exames de sangue, que descartaram muitas dessas condições.
Some disorders require specific tests which I can't see Patient 1 has yet had and it would be worth getting these done. These include tests for lúpus (an inflammatory disorder), magnesium deficiency, deficiência de zinco, Doença de Lyme (infection resulting from a tick bite) and síndrome de taquicardia postural (increase in heart rate on standing). I also think detailed examination and investigation of his neck (cervical spine) would be worth pursuing.
If all these tests are normal, one would be thinking in terms of primary headache (without an underlying secondary cause). Primary headaches are diagnosed in 9 out 10 cases of headache. Common types include cefaleia tensional, enxaqueca, e cefaleia persistente diária. O diagnóstico depende do padrão dos sintomas e de investigações para descartar causas subjacentes. Embora existam terapias específicas para algumas cefaleias primárias (enxaqueca sendo um exemplo notável), em muitos casos, o tratamento é uma questão de tentativa e erro.
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Medicamente inexplicado
Voltar ao conteúdoÀs vezes, apesar dos melhores esforços da profissão médica e de uma bateria abrangente de investigações, as pessoas ficam sem qualquer explicação para seus sintomas. Os médicos (que adoram rotular as coisas) têm até um nome para essa situação - 'sintomas sem explicação médica' (MUS). Isso significa exatamente o que está escrito - ninguém está negando que a pessoa tem os sintomas; é simplesmente que os médicos não conseguiram encontrar uma condição médica para explicá-los.
Some people with MUS undoubtedly do have stress/anxiety, whether as a result of the symptoms or as a cause of them. I would encourage the poster to continue to pursue psychological support, as this may help to relieve a potential cause as well as helping him cope with the symptoms. Terapia cognitivo-comportamental would be ideal for this purpose, as would consciência plena - a technique which would arm him with a way of deflecting his mind away from his troubling symptoms.
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Histórico do artigo
As informações nesta página são revisadas por pares por clínicos qualificados.
13 Fev 2018 | Publicado originalmente
Escrito por:
Dr Laurence KnottRevisado por
Dr Sarah Jarvis MBE, FRCGP

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