Memory Loss and Confusion

Hi, I have had MAV for many years now, but in January had a very strange incident. I was tidying away Christmas decorations and putting them up in the loft. I was putting the last thing up there and thought this is heavy, but carried on. That was the last thing I remember until a few minutes later. I don’t remember going into the loft, coming out, or putting the ladder and cover back. I was then confused for a few hours, went to A&E, had investigations including a CT scan. All normal, they said probably a new migraine symptom. I have since had an appointment with my neurologist who ordered an MRI, that is normal too.

My head has not felt the same since. Migraines have increased, and if I do anything where I am exerting myself more than usual, it feels like my head is in a clamp, with pressure from the sides. I’m on the Ajovy injections, and have started using the Cefally device on preventative more, which I think is starting to help, but I just don’t feel myself.

Has anyone else had this happen? Any ideas? Thank you!

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This sounds like brain fog. It’s very common and very debilitating.

It’s (not so) funny how the condition morphs as the years go by.

@DizzyBot can you please share some posts about brain fog?

It seems like brain fog is indeed a topic many have shared their experiences on. Here are a couple of posts from the forum that might offer some insights:

  1. Onandon03 shared on November 22, 2019, comparing brain fog to the spinning circle on a computer screen indicating the system is overloaded. They suggest that just as a computer needs to rest to regain full functionality, so does the brain.

  2. On the same note, Onandon03 also described brain fog as when “you cannot think straight because the system is struggling,” in a post from August 11, 2019.

  3. Jools explained their personal experience with brain fog on January 14, 2020, noting it as a symptom that lingers after their migraine attacks. They detailed how it impacts their cognitive function significantly, slowing down their mental processes and affecting memory and speech.

These accounts might resonate with the experience described by @mags about confusion and memory loss post-exertion. It’s a comforting reminder that they’re not alone in navigating these symptoms, and communal sharing could offer strategies for coping or at least a sense of solidarity…

Thanks very much for your replies, they are very interesting. I didn’t know that brain fog could basically wipe your memory for a while. There are at least ten minutes of continuous loss, and then patchy loss after that. The comparison to a computer being overloaded makes a lot of sense, so thank you. I’ve had brain fog before but never like this, and I am now banned from doing anything that overexerts me.

It really is comforting to know that I’m not alone, although I’m sorry that we have to go through this. It is strange that after all these years (approx 45!) of some form of migraine, yet another symptom appears.

Thanks, I do feel reassured.

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Look at it this way: if it morphed to this point, it will morph again and you will no longer get this specific symptom.

I have had but no longer get brain fog (horrible!) and I no longer get scintillating scotomas either.

One weird one I had was a kind of aching forehead, like a brain ache, very odd!!

Hopefully I don’t get it again, it was seriously scary.

That does sound like an odd one.

I think this is Transient Global Amnesia. This has recently been reviewed in NEJM a9see below), when it was concluded that its cause was unknown. I suspected that this was a rare complication of Meniere’s disease, and so am currently checking this out. So far I have identified Charles Darwin and the anatomist John Hunter as having TGA along with their Meniereiform attacks. The main characteristic of endolymphatic hydrops, the pathological basis of Meniere’s disease, is a feeling of fullness or pressure in ear(s)/head.

Transient Global Amnesia

Author: Allan H. Ropper, M.D.
Published February 15, 2023

N Engl J Med 2023;388:635-640

DOI: 10.1056/NEJMra2213867

VOL. 388 NO. 7

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Thanks for your reply. That’s what I thought it was, but my consultant said he didn’t think it was. I do still wonder though. Good luck with your research, it’s very interesting.

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I assume your consultant was a neurologist. Just because some memory disorders are due to proven brain damage, it does not follow that all cases are. If TGA were due to brain lesions or of neurological origin, we would have found this out long ago. Conan Doyle’s mentor, Joe Bell, spent a long time churning over why slight knocks on the head could produce serious memory deficits, since he knew they could not be damaging the brain. Answer: the vestibular inner ear is very sensitive to head blows, slaps on the ear, blasts, etc.

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That’s very interesting.

I’ve seen people here on this board and elsewhere with “VM/MAV” symptoms after:

  • minor trauma to ear jumping into a swimming pool
  • car crashes

and in my case, some 5 months before MAV started:

I pointed a shower into my ear (which was followed with 5 weeks of imbalance which appeared to completely resolve …).

No doubt there are many people here with ear/head symptoms after plane landing. Transient Global Amnesia has been reported after cold sea bathing and hot baths/showers (and, no, this does not damage the brain!). I am confident this is due to perilymph fistulae, ie round or oval window ruptures. These usually heal, but are liable to reopen upon mild trauma.

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Either that or theoretically could cause Secondary Hydrops with a symptoms list that is identical to MAV …

there’s also the possibility of psychological impact that affects the firing of the Tonic Tensor Tympani muscle, causing a form of TTT syndrome.

I personally still have hyperacusis in my bad ear.

(these are all great theories, but they need to be matched with objective diagnostics and a better treatment plan!)

Yes, he is a neurologist specialising in headache disorders. He said this before I had my MRI, just based on the history that I gave him.

doesn’t seem like TGA – TGA is its own clinical entity where the cause is unknown and not associated with any other neurological etiology. Migraine can cause temporary blackouts like this, and especially since it was only a few minutes and not hours, TGA is probably not the right assignment (neurologist is right).

my very first extreme vestibular migraine started after a powerful aura event, which then kickstarted the chronic phase slowly over the course of the next couple of months. very profound migraine auras can be similar to epileptic-like disruptions in brain activity that can affect memory circuits in the brain – very likely that this could have been part of an aura that preceded the more chronic illness that you’re in now

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Thank you for your reply. I suppose it was a blackout really. It was so weird because I carried on as usual, and did what I was meant to be doing with absolutely no memory of it. I have had migraines for 45 years and I have never had anything like this, but obviously the wonderful world of migraine always has something new up its sleeve!
It is only in the last couple of weeks that I feel like I’m getting back to how I was before this happened in January. That’s hopeful I suppose.
Thanks again, it’s good to know and very helpful.

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And that’s where migraine might come in?

Not that I’m discounting potential influence of inner ear (or even middle ear)

I think inner-ear problems can absolutely trigger central nervous system dysfunction; its almost like an adversarial signal that gets sent to a susceptible CNS that wreaks havoc

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I think you should write up your case for publication in a reputable medical journal, since:

  1. TGA is not well known, and its cause is still unknown.
  2. Short TGA is not well documented, though surgeon John Hunter was OK after half an hour.
  3. Probably about ten cases can be mustered from the literature of TGA associated with Meniere’s Disease or endolymphatic hydrops, starting with C Darwin and J Hunter, so it can’t just be coincidence. (Plus some others from this site?).
  4. The vestibular organs are strongly linked to the hippocampus and to memory formation.
  5. There is confusion in the Meniere literature as to whether there can be loss of consciousness during attacks. I suggest that transient loss of memory is common, so the person can’t remember if they lost consciousness or not.
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Invoking migraine does not help, since its cause and location is unknown. I can see no reason why migraine can’t simply be regarded as a vascular reflex triggered from the inner ear. It is an intermittent condition, like endolymphatic hydrops, with similar causes and epidemiology.
Does anyone know of a cause of migraine that is not also a cause of Meniere’s Disease?

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channelopathies and mitochondrial dysfunction