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Living with Lupus

Brain Symptoms, Brain Fog, and Lupus

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Brain symptoms are the least acknowledged and most misunderstood symptoms of lupus. But over 50% of patients experience some sort of brain symptom in the course of their disease.

Neuropsychiatric symptoms happen when lupus affects the brain, spinal cord, or any of the other systems of nerves in the body. The symptoms can show up in many different ways, but what all of the symptoms have in common is that they can influence almost every aspect of a person’s life. Given how prevalent they are and their effects, it’s hard to believe how infrequently doctors consider these symptoms a priority. People with lupus who have neurological symptoms might find themselves disbelieved or, at best, believed but not helped.

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Symptoms of Lupus in the Brain

Brain-based symptoms of lupus can be complicated to diagnose, are often subtle, and can be easily ignored. Some of the most notable symptoms of lupus in the brain include:

The problem is that all of these symptoms can have causes other than lupus – or be caused by the stress and exhaustion that comes from living with a chronic illness like lupus. You can read more about the symptoms here.

Many of these brain and nervous system symptoms are not fully understood, either, especially the symptom known as “Brain Fog.”

Brain Fog and Lupus

“Brain fog” is the colloquial term for the difficulties that many people with lupus face with concentration, memory, and thinking. It is called such because it can feel like your brain is clogged with a thick fog, trying to move through molasses, or covered by a thick blanket. It is a very frustrating symptom, as your thoughts struggle to manifest and become actions, and it often takes extra effort to understand something or get a task done. You can read more about brain fog here.

Brain fog is an extremely common symptom of lupus, but often misunderstood by people not familiar with chronic illnesses. It can flare up like any other lupus symptom, but it can also be caused or exacerbated by fatigue, pain, and improper nutrition. It can also be a symptom of sleep deprivation, which can be caused by worry and pain.

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How Does Lupus Attack the Brain?

Scientists currently believe that lupus attacks the brain through two different ways:

  • Through the Blood-Brain Barrier: Lupus disrupts the membrane that separates the blood supply of the brain from the delicate nervous system tissue of the brain itself. This barrier, called the blood-brain barrier, blocks hormones, chemicals, and other materials including immune system. Particles such as antibodies in the blood stream from affecting the brain. 
  • Through the Bloodstream: Lupus can increase the risk of strokes and heart attacks. Additionally, it can interfere with proper blood flow by damaging blood vessels and causing rigid vessel walls, narrowing, and clots. 

Certain medications, including Non-steroidal anti-inflammatory drugs (NSAIDs) can cause headaches, dizziness, and confusion, as well. Corticosteroids and antimalarials can cause agitation, confusion, mood swings, psychosis, and depression.

It is very important to make sure that the medication is not the issue, or that lupus isn’t masking or exacerbating a different health problem that might be causing the neurological symptoms.

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Diagnosing Brain Symptoms of Lupus

MRIs and other brain imaging devices can detect damage, but usually lupus-related symptom are not actually brain damage, and so cannot be easily seen on an MRI. A lumbar puncture, also known as a spinal tap, can detect major potential issues that would show up in the cerebrospinal fluid. Most lupus-caused symptoms would not show up in such a test. However, these methods can find other issues that could be mistaken for lupus. Catching masked problems, such as infections, brain hemorrhage, cancers, and certain inflammatory conditions (such as MS and Guillain-Barre syndrome,) is vital and can save lives. So they are important tools in a Lupus Warrior’s arsenal if more serious issues are suspected.

Electroencephalograms, also known as EEGs, are much more effective at detecting lupus-related brain symptoms as they detect changes in brain activity.

Better, however, is observing the symptoms from the outside, as the person experiences them. Lupus-related symptoms come in many forms, but they do occur in patterns that a qualified psychiatrist can recognize.

Treating Brain Symptoms of Lupus

Medications that treat the symptoms of anxiety and depression are often prescribed. However, as with many other symptoms of lupus, taking care of your body with proper sleep, nutrition, exercise, and hydration can help bring down the symptoms greatly.

Comments (20)

20 thoughts on “Brain Symptoms, Brain Fog, and Lupus

  1. So why is it that physicians tend to think people are “pretending” to be sick? The last thing I want in my life is criticism from someone on the outside looking in. FYI: I hate hospitals and terrible doctors with a passion that burns so deep. Chronic illness(es) are not fun nor are they a “figment of the imagination.”

    1. I feel the same way you do, @JD. But hard as it may be to believe, there are people out there who pretend to be ill. Maybe it makes them feel better psychologically to have someone make a fuss about them. Maybe they just want attention. Whatever the reason is, they end up making life harder for those of us who really are sick.

  2. It’s maddening when this happens. I feel like I’m having trouble focusing when a lupus flare involves brain function. I am at work trying my best and thinking I’m doing okay. The next day or two the mistakes start to show up in the data base, orders and notes that I make. It makes me sad and I keep thinking that work may lose patience with me at some point. I don’t want to go on disability though.

  3. I agree JD lupus warriors do not want to be sick, we fake being well and minimise our symptoms as we don’t wish to burden others! I get tired of explaining my symptoms to others so now I just say NO to their requests, I’ve had a few surprised looks but interestingly they have not asked for me to explain the NO?!

  4. The thing that I don’t understand is when you explain or express changes that happening to your body, brain or total physical health they look at you like your crazy. I think the health care “physicians” should be more educated or trained on how to treat Lupus!!

    1. I am literally having this problem and dont know what I have but I literally have of the symptoms on that list with exception to the seizures. I have been freaking out for months trying to figure out what is wrong with me and was told that I just have migraines. My husband is also tired of me researching trying to figure out what is wrong and thinks Im losing it. I even had my doctor ask if I wanted to see a counselor because I am fine. Im like “I am dizzy like I am drunk having headaches and cant think straight, I am not fine”. Trying to ask doctors the possibilities of other things is a headache too. they think you just think you have everything when you are trying to get to the bottom of what is wrong so you can feel normal again.

      1. I feel the exact same way & ive been explaining my everyday dizziness as a drunk feeling also. I’ve been sick for 6mths now with no answers. My docs do the same thing!

      2. I have all of the above as well and more except the seizures. I have had many jerky movements that comes with muscle spasms too. Sometimes, I’ll be sound asleep and get jerked awake I often wondered if they are petit mal seizures since I have never been know to have them. I started out being very tired, having conjunctivitis to brain fog, auditory hallucinations, nausea, Vertigo, either diarhea or constipated, muscle spasms, all over body pain, weakness, pin and needles ( confined to rt thigh), tingling, numbness everything, blurry vision, double vision, floaters wheezing, cant get my temperature to regulate,, going from hot to cold in mins, enlarged heart, sore throat, inflamed sinuses, runny nose, either dried out or watery eyes, head aches, brain fog, memory problems, word recollections, forgetting my own name at times even, driving and forgetting where I am going, moody, extreme anxiety, depression, insomnia, irritable, and off hand, cant remember what else. Only what I am feeling right now. My throat hasn’t been sore finally for 2 weeks after being sore for almost 8 months straight! I’ve had several tests to rule things out and the last dr at urgent care seems to think its all mental. I am not ashamed to admit if it s all mental but I don’t believe for a second its all mental. I just don’t think any of the drs I have seen don’t care to find out what is the real problem. I’m blaming it on mold poisoning only bc my daughter experienced about 5 of these same symptoms only she got rashes 2x within a yr and I didn’t, I have never seen a neurologist either.

        1. It took me finding the right rheumatologist to properly diagnose and treat my Lupus. The good news is she believes me and is trying her best to treat. The bad news is I have had to stop the first three medications because of side affects. Don’t give up on yourself and don’t be afraid to continue your search for a knowledgeable and caring physician.

      3. Tatiana, Don’t give up! Find a different doctor. If that one doesn’t listen, find another one. I don’t have Lupus but I do have MS. It took me 5 years and more doctors than I can count before I found one that would actually listen and do something. But before that, one doctor told me it was psychological and sent me to a psychologist. It was the psychologist that told me I was Not crazy and referred me to the doctor that finally helped me.
        The symptoms of Lupus and MS are so similar. I also have the dizziness, brain fog, blurred vision, memory issues, etc… It’s all very frustrating but finding that one doctor that listens makes does help. Good luck to you and God Bless

      4. Tell your doctor that you want a ANA test done. It’s just a simple blood test that will show if you have lupus

  5. I have Celiac, mthfr and hashimoto’s. When I get a flare up due to inflammation or exposed to some thing I get brain fog, memory issue and I do feel drunk. My new symptom is double vision. I take no medications. I do supplements , mostly grain and dairy free. No sugar. I haven’t quit coffee. Tea has fluoride that effects my thyroid. I am still working.

  6. I have been diagnosed with lupus for 35 years plus rheumatoid arthritis. I’ve been experiencing memory loss in the last couple years. I tell my family I may end up with alzheimers because sometimes I’m embarrassed about not remembering things alot. I never thought it could be associated with my lupus. I will be discussing this with my doctor.

    1. Oh, sweetie I feel the same way. I tell my family all the time I need to be checked for early Alzheimer’s. I’m an avid reader and know (or used to know how to spell) how to pronounce words. Here for the last year I can’t pronounce anything. It’s like my brain and mouth will not work together.
      Words won’t come to me. The simplist ones I know. I’m 48, and was diagnosed in 98. It started getting bad about 5 years ago. Nothing makes me madder than for my husband to go behind me and check every little thing I tell him. Now my grown sons are doing it. How much more pride can you lose?! I always say someone has it worse than me (about everthing) when I get in self pity mode.

  7. These are articles and comments are so helpful to me. It helps to decrease the isolation I feel with this disease. I have been living with Lupus for 25 years. I have dealt with everything from acute kidney failure to hair loss and everything in between. But this brain fog piece is by far the most challenging thing I’ve had to face as it affects so many areas of my life. Thanks everyone for being so open with your experiences.

  8. I’ve been diagnosed with Lupus and Hashimotos for @ 3 years but have had symptoms for probably 10. One of the most frustrating is the confusion and memory issues I have that periodically get better and worse with flairs. I find I have to concentrate so much harder on everyday tasks in order to perform them, ,especially while driving. I’ve also noticed my hearing gets worse during these episodes. The problem with the Drs taking these symptoms seriously I feel has to do with a lack of correlation between symptoms and solid lab data – lab results very so much and do not always reflect the presence or severity of a particular symptom at all. Stay strong #LupusWarriors

  9. I’m presently at the hospital, with my wife lying down beside me. She was diagonised with SLE around 3 months ago, this month was her first Lupus Flare, and it was devastating. In our 19 years of maritial bliss, I had never seen her in this state, it breaks my heart everytime to see her struggling to do even the simpliest of tasks. She is the most amazing woman I have ever known and now she is not herself.When will this flare be over? Please advise.

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