It's all in your head
Over the years I have seen numerous patients who complain of many neurologic and psychiatric conditions. Often when a patient complains of more than one or two problems – many physicians can get overwhelmed. It is difficult to treat a patient who seems to have a multitude of problems that at first glance may not appear to be related. Part of the issue is that medicine is moving in the direction of treating symptoms and not the underline cause of the problem.
When I see a patient who is complaining of: Headaches, Insomnia, Depression, Anxiety, Dizziness, Concentration problem, Brain Fog, Memory disturbance, Visual problems and others I start with an extensive history. I want to know: when did these symptoms start? How long have they been going on? Did they all start at the same time? Are medications helping the symptoms? What was done by other doctors to work up these complaints?
Often what I hear is that all test results were negative, medication is not working, symptoms have been going on for months or years and have started either at the same time or a few weeks/months apart and are either not going away or have gotten worse.
Frequently, these patients receive a psychiatric diagnosis and the bulk of their symptoms are managed by their psychiatrist. In my practice which primarily deals with Neurologic Manifestations of Lyme disease and associated illnesses, I see a great deal of these patients. My experience and the use of a number of tests such as MRI, SPECT/PET scan, LP, Blood work, EEG, VNG, Neurocognitive assessment has led me to believe that many of these patients are suffering from Infections Induced Autoimmune Encephalitis.
Infections Induced Autoimmune Encephalitis is essentially and inflammation of one’s brain due to a break in the blood brain barrier which produces a picture of Encephalitis that manifest itself with symptoms of: Headaches, Insomnia, Depression, Anxiety, Dizziness, Concentration problem, Brain Fog, Memory disturbance, Visual problems and others. These patients’ symptoms are not only refractory to psychiatric medications but some do worse and have trouble tolerating these medicines because many psychiatric medications work by causing an increase in excitatory neurotransmitters in the brain which patients with infections induced autoimmune encephalitis have trouble tolerating.
Identifying the cause of one’s Headaches, Insomnia, Memory Issues, and Mood problems is key in my practice as often for many of my patients these symptoms arise out of the blue and are puzzling. Ones the cause is identified and treated effectively the symptoms resolve!
Elena Frid MD
Pediatric and Adult Autoimmune Neurology Specialist