Clouding of Consciousness
Clouding of consciousness, also known as mental fog[1] [2] [3], is a conventional medical term describing an abnormality in consciousness. The sufferer experiences a subjective sensation of mental clouding described as feeling "foggy".[4] More specifically, it is an abnormality in the "overall level" of consciousness that is mild and less severe than a stupor or coma.[5] Thus, some authors prefer the more objective term “abnormal level” of consciousness over the subjective term “clouding” of consciousness. In the 1817 German treatise Verdunkelung des Bewusstseins, Greiner first coined and pioneered the term clouding of consciousness as the main pathophysiological feature of delirium.[6] It is poorly recognized and poorly researched by conventional doctors, who tend to mislabel it or “psychologize” it.[7] [8] Alternative medicine practitioners popularly use the term “brain fog”; however there is no mention as to whether they intend the term to be synonymous with the conventional medicine term clouding of consciousness.
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[edit] Pathology
The precise pathophysiology is very poorly understood. However, the general conceptual model is that of a part of the brain regulating the “overall level” of the conciousness part of the brain.[9] Various etiologies can “funnel” in on and disturb this common regulating part of the brain, which in turn disturbs the “overall” level of consciousness.[10] The key idea here is an abnormality in the “overall level” of consciousness, referred to also as wakefulness or arousal, as opposed to an abnormality in specific or focal parts of consciousness.[5] Thus, the contents of consciousness such as alertness, awareness, attention, memory, orientation, language, comprehension, recognition, thinking, perceptions, emotions, executive abilities, etc. are said to be disturbed in a “diffused” or “widespread” or “global” manner as opposed to a specific manner.
[edit] The Subjective Experience
Barbara Schildkrout, MD, a board-certified psychiatrist and clinical instructor in psychiatry at the Harvard Medical School described her subjective experience of clouding of consciousness, or what she also called “mental fog”, after taking a single dose of the antihistamine chlorpheniramine for her cottonwood allergy while on a cross-country road trip. She described feeling "out of it" and being in a "dreamy state". She described a sense of not trusting her own judgment and a dulled awareness, not knowing how long time went by.[3]
[edit] Alternative Medicine's "Brain Fog"
Coming soon.
[edit] In Movies and Art
In the fifth episode of the third season of the television series Mad Men, the title of the episode “The Fog” is a reference to Betty's drug-induced delivery room delirium.[11]
In the 1990 romantic comedy film Joe Versus the Volcano, Joe (Tom Hanks) is tricked into becoming a human sacrifice for a volcano. Knowing that Joe is a hypochondriac, an unscrupulous doctor diagnoses Joe as having an incurable “brain cloud”. The movie mocks the concept of clouding of consciousness and people who complain about it.
[edit] References
- ^ "Taber's Medical Dictionary". http://www.tabers.com/tabersonline/ub/view/Tabers/143618/0/mental_fog.
- ^ Dorland's Illustrated Medical Dictionary. Elsevier Health Sciences. 1994. pp. 343.
- ^ a b Barbara Schildkrout (2011). [books.google.com Unmasking Psychological Symptoms]. John Wiley & Sons. pp. 183-184. books.google.com.
- ^ Augusto Caraceni & Luigi Grassi (2011). [books.google.com Delirium: Acute Confusional States in Palliative Medicine]. Oxford University Press. pp. 82. books.google.com.
- ^ a b [books.google.com Plum and Posner's diagnosis of stupor and coma]. Oxford University Press. 2007. pp. 5-6. books.google.com.
- ^ Augusto Caraceni & Luigi Grassi (2011). [books.google.com Delirium: Acute Confusional States in Palliative Medicine]. Oxford University Press. pp. 2. books.google.com.
- ^ Yudofsky & Hales (2008). [books.google.com The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences]. American Psychiatric Pub. pp. 449. books.google.com.
- ^ MacKinnon & Michels & Buckley (2009). [books.google.com The Psychiatric Interview in Clinical Practice]. American Psychiatric Pub. pp. 462. books.google.com.
- ^ Augusto Caraceni & Luigi Grassi (2011). [books.google.com Delirium: Acute Confusional States in Palliative Medicine]. Oxford University Press. pp. 19-20. books.google.com.
- ^ Yudofsky & Hales (2008). [books.google.com The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences]. American Psychiatric Pub. pp. 477. books.google.com.
- ^ ""The Fog" Television Criticism by Myles McNutt". http://cultural-learnings.com/2009/09/14/mad-men-the-fog/.
