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Cognitive Dysfunction

I have been experiencing progressive cognitive dysfunction for around 2 years. Have had normal MRI's / MRA / CT scan / psychoevaluation.. Deficits include memory, planning, complex thinking, processing speed, etc. Have had multiple elevated ANA's, as well as chronic lymphdenopathy. A sudden food allergy has emerged as well. Prozac has not changed the cognitive symptoms either. Frequent headaches occur as well. An indentation in the left side of skull has also begun to develop. Any ideas would be appreciated.

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Avatar universal

Sorry to hear of your suffering. I'm not a doctor, but after hearing your symptoms I have one idea you could pursue further with a doctor. You may want to see a rheumatologist. If the ANA titers read as elevated (like over 700 or 1000 to 1) some of your symptoms could point to Lupus (SLE) with central nervous system involvement (CNS).

Lupus isn't curable but it can be managed. In my experience, it is best treated by a healthy lifestyle -overhaul-, and using medications conservatively, only as needed to treat specific conditions before they have the opportunity to get out of hand. It's not an easy condition to diagnose and individualizing the treatment can be complex for the doctor-- leaving patients scared, confused, desperate for answers (that don't exist), and vulnerable to being over-medicated.

My best advice to anyone who may find themselves on this road is to, above all else, maintain a healthy perspective. Don't get lost in lists of symptoms, categorizations of diagnoses, and trying to separate the illness from the side-effects of fifty different meds your doctor(s) put you on. Just don't "go there."

If this is what you're facing, your perspective will be essential to forming a "game plan" that's right for you, and staying on track (while maintaining good communication with your doctor). For example, my way (which I eventually came to after learning the hard way) was to accept that I would deal with 95% of my symptoms with lifestyle changes (which was a HUGE undertaking, but that's me), and deal with the worst 5% medically, unless the doctor insists that something is critical and there is no other solution but medical intervention. Maybe something like 70%/30% might be more palatable and sustainable for someone else.

Whatever your future holds, good luck-- and I really hope you start feeling better soon.

Sincerely, (sleepy) Meisja
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Avatar universal
MEDICAL PROFESSIONAL
Hi there. Cognitive dysfunction means poor mental function , associated with confusion, forgetfulness. A number of conditions can cause this like heavy metal poisoning like mercury, menopause, fibromyalgia, ADHD, and sleep disorders. You need to consult a neurologist for an evaluation of this cognitive dysfunction. Hope you get some help and take care.
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Avatar universal

Hi Doctor Sharma.

While all the things you mentioned are certainly possible, I suggested NP-SLE mainly because of the elevated ANA titers asdf1122 spoke of. I was careful to note a minimun range that I understand the Johns-Hopkin's rheumatology team considers worthy of notice (even though a titer as low as 160:1 can be construed to be above and out of the "normal" range, it's not considered definitive).

Of course their treating doctor, once chosen, will have their own opinion as to what they feel is a significant threshold. In my view, the fact that rheumatologists are specialists in reading and interpreting these tests takes nothing from a co-treating neurologist, and could only benefit the patient who may be in need of just such a multi-disciplinary approach to their care. (It's a long story, but I also know my neuro would appreciate my clear acknowledgment of this, too. Lol.)

I imagine Fibromyalgia could present elevated ANA in tests, too (being that it's a related condition in the auto-immune "family"), but the thread-writer didn't list any kind of body or joint pain suggestive of that in their post.

I think it's great, and I'm truly appreciate that you're here, Doctor, so I hope you can understand the reasoning behind what is urging me to be contrary-- I just think it would be unfortunate if this person went solely to a neurologist, who might not think to pursue the auto-immune possibility (which may be quite clear) before exploring a dozen other avenues for little gain or understanding of the underlying issue.

This is a common story for many Lupus patients who went undiagnosed for years in just such a scenario. Identifying and treating each symptom set can be very taxing emotionally, and that stress can be counterproductive, triggering "flares;" a vicious circle, if you will.

However, once armed with the diagnosis and understanding the connection of what goes on in their bodies and causes all these symptoms, these patients are able to find the guidance they need to adapt and make changes in their lives that in many cases could lessen the impact or even prevent some flare-ups from occurring. Obviously, this "story" is not an unfamiliar one to me, either, and if I can spare someone by encouraging them to seek (all) appropriate specialists, keep a healthy perspective, and learn to live and adapt in healthful ways, I've got to do that.

While I strongly believe they're crucial for people who may be facing SLE, I think those suggestions could be helpful to many, regardless of the specific diagnosis.

Thanks for listening, and, again, for taking your time to help and inform us.  :)
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