Ask the Doctor: Infections & Cognitive Problems; Migraines & PD Risk; Grief & Depression
Q: Can an ordinary infection cause cognitive problems? Can these problems be reversed?
A: A number of infectious agents can cause cognitive symptoms such as memory difficulties, confusion, extreme fatigue, problems focusing, and other issues. Examples of common infections that can affect the brain include Lyme disease, encephalitis, meningitis, abscess of the brain or spinal column, and West Nile fever. If not treated, these infections may sometimes lead to permanent damage to the brain by causing pathological changes in brain tissue, by triggering an immune response with inflammation that damages brain tissue, or by promoting toxic levels of the neurotransmitter glutamate that leads to the disruption and death of brain cells. However, the good news is that medications such as antibiotics and anti-inflammatories, supportive care (administration of fluids and prevention of secondary infections such as pneumonia), and sometimes surgical drainage of infected tissue can address these issues and lower the risk of permanent damage.
Q: I have suffered from migraine headaches since I was in my teens. Recently I read that a history of migraines is associated with higher risk for Parkinson’s disease. Please tell me more.
A: A study published Sept. 17, 2014 in the journal Neurology suggests that individuals who experience the painful, throbbing headaches called migraines in midlife may be at greater risk in older age for Parkinson’s disease (PD) and certain other movement disorders. PD is a neurodegenerative disorder that impairs movement and balance, causes tremors, slowed movement, and stiffness, and may eventually lead to dementia. Both migraines and PD are thought to be related to abnormalities in the brain’s dopamine system. The study did not prove a cause-and-effect relationship between migraines and PD, however. The researchers reviewed 25 years worth of data on more than 5,500 adults aged 33 to 65. During that period, 4,000 participants reported no headaches, 1,028 reported non-migraine headaches, 238 reported migraines with no aura (tingling and flashes of light), and 430 reported migraines with aura. About 20 percent of participants who reported migraines with aura also reported four out of six symptoms of PD, compared to only 12.6 percent of those with migraines but no aura, and 7.5 percent of those with no headaches. Although interesting, this study calls for further research, and should not raise too much concern. The study authors emphasized that although their results indicate an increase in risk, PD is still uncommon among people with a history of migraines.
Q: My 72-year-old sister was widowed two years ago, and is still deeply depressed. Treatment for depression didn’t help her. Can you suggest other options?
A: Your sister may be experiencing a severe form of grief known as complicated grief, which is often mistaken for depression. Complicated grief often does not respond well to standard therapies for depression. Your sister might consider asking for a referral for grief therapy, a special type of therapy that includes strategies such as encouraging the patient to resume activities associated with the deceased and revisit familiar places that might remind them of their loved one, asking the patient to record a description of the loved one’s death and listen to the recording at home, and addressing the patient’s fears about forgetting the deceased person by encouraging the individual to record memories and keep a few items associated with the loved one nearby. A study comparing individuals who received grief therapy to those who received standard therapy for depression found that after 16 weeks 70 percent of those receiving grief therapy experienced a significant improvement as opposed to just 33 percent of those who participated in standard therapy.
The post Ask the Doctor: Infections & Cognitive Problems; Migraines & PD Risk; Grief & Depression appeared first on University Health News.
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