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Cognitive Dysfunction During Migraine Attacks

Cognitive Dysfunction During Migraine Attacks

Feeling like you can’t think clearly and unable to comprehend even simple topics of conversation, your mind is in a fog. Not being able to pay attention, find words you’ve known since you were two, or make rational decisions. Looking at words on a page and wishing you could follow their meaning, but knowing you won’t remember what you read anyway. These are all examples of cognitive dysfunction during a migraine attack.

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A look at the research

People with migraine have reported for ages that their minds don’t work normally during attacks; some even find it to be more disabling than the pain. Research on the topic has been difficult and inconclusive, but quality studies exploring cognitive dysfunction and migraine attacks continue to mount. (Diana’s article from last year, Cognitive Dysfunction and Migraine, explores some of the issues researchers have encountered when studying this.)

A study published in the October 2014 issue of the journal Cephalalgia teaches us even more about cognitive dysfunction during migraine attacks. Participants with episodic migraine without aura were given a slew of cognitive tests during an untreated attack and when they were not in an attack. During the attack, they performed worse on the majority of the tests than they did when between migraine attacks, particularly in speed of reading words, learning verbally, and recalling verbal information in the short- and long-term. Difficulty recalling verbal information occurred whether participants were asked to list words spontaneously or were prompted with a definition first.

The role of pain

Difficulty thinking during a migraine attack is often attributed to the pain. While this study doesn’t solidify an answer to that question, researchers argue that cognitive dysfunction appears to less about the pain and more about the brain’s activity during the migraine. One reason for this is that cognitive dysfunction arises in the earliest stage of a migraine attack, even before the pain begins. Even when acute medications work for the pain, cognitive dysfunction can remain. Only learning and memory worsened with the severity of the pain; the other symptoms of cognitive dysfunction happened no matter what the pain levels. The pain also lingers in the migraine hangover, which follows the pain phase of the attack. A person can even have cognitive dysfunction if they have a migraine attack with no pain at all.

People with migraine, particularly frequent or chronic migraine, often worry that these difficulties thinking represent permanent changes in the brain. The research shows that cognitive dysfunction is reversible and does not last after all the stages of the migraine are over.

My experience is only one anecdote, not scientific research, but I identify with so much of what this study says. Cognitive dysfunction is not noticeably dependent on pain levels for me. I can have mild pain and severe cognitive dysfunction or horrible pain with no trouble thinking. The cognitive dysfunction could stem from my brain processing pain that I’m not feeling, but that’s hard for me to believe, especially given that I can sometimes think just fine even with severe pain.

Temporary disruption

After years of daily migraine, one of my biggest fears was that my intelligence was eroding permanently. Now that there’s space between my migraine attacks, I can see that the cognitive dysfunction is temporary. It’s such a relief. Migraine feels so violent. It seems like the brain couldn’t possibly undergo such assault and come out unscathed. It’s always nice when research can soothe those worries.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Gil-Gouveia, R., Oliveira, A. G., & Martins, I. P. (2014). Cognitive dysfunction during migraine attacks: A study on migraine without aura. Cephalalgia, 0333102414553823.

Comments

  • mammapeaches (Susan McManus)
    3 years ago

    I find that I don’t remember things long term if I had a migraine during an event. I have said to my daughter, I don’t remember that movie we saw and she will say remember, you had a migraine and so it did not process in my long term memory.

    I also hate meeting someone new when I am “impaired “. They are not meeting the real me!

  • Luna
    3 years ago

    Cognitive dysfunction and pain do not correlate with me. I have more thinking dysfunction with silent migraine than with acute attacks.

  • Tim Autry
    4 years ago

    My Cognitive Dysfunction or Impairment has been lurking in various stages, just as the pain, since this migraine started back in October 2013.
    Sometimes I’m doing something or talking and all of a sudden my mind goes blank.
    Other times I’m cruising right along and poof, how am I going to do this, and it has been my job for the past 30 years.
    So just like life, I don’t really know what I do know and what I don’t know.
    At times I’m doing things and it is like deja vu, I’ve done this before.
    It happens whether I’m doing a mental or physical task, things are always changing.
    They told me what I have is an “intractable” migraine” and I said yes, how do we get rid of it.
    Well I found out, nothing treats it, you just grin and bare it until it decides to go away.
    I’ve been told I’ve had 3 of these types of episodes in the past, one for 3 months and 2 for around 6 months, but this one is…
    Well you can tell from my rambling on I’m have not got all 8 cylinders firing correctly, for now.
    And Kerrie, good article, and to a computer software engineer/programmer/analyst like me, it is devasting to have the cognitive impairment, I’d rather have a lot of pain and still do what my career demands of me.
    Oh and to all others, my intractable migraine, I never lose the pain, it varies most of the time around a 2 or 3, but as I work my mind, it can go up to the 5 or 6 range, and at times it can go 7 to 9. The rescue/abortive meds work, but they just bring me back down to a 2 to 3 livable level. My aura comes and goes, the paralysis on my left side comes and goes, varies maybe only my hand or foot, sometimes I lose vision in my left eye, or all my senses go haywire and straighten back out.
    Like right now, I’m trying to remember the word for when you can hear/speak language correctly, but I get very sensitive to bright light, loud noises, strong smells (sometimes my nose plays tricks, like I smell something burning or I think the wife is cooking chili but she’s not even cooking), it hurts to be touched, way down into the hair roots and taste, well I never know what anything is going to taste like.
    I’m hoping in the very near future this one goes away, there’s a lot of pictures of family things my wife, children, parents and I were doing, but I don’t remember them anymore.

  • AudreyB
    4 years ago

    The sensation I feel is that I can’t handle any inputs and don’t want to attempt any outputs. Then during and after the prodrome, functioning slowly returns. This is why the triptans often didn’t work for me: my brain seems to need to complete the entire cycle. It will be wonderful when we have better knowledge about what’s happening with our brains. (And I’m more worried about Parkinson’s than I am about Alzheimers…that’s what the migraineurs in my family have had.)

  • minddoctor
    4 years ago

    During yesterday morning’s migraine I placed my phone into a full glass of drinking water and rolled over and went back to sleep!

  • Ohio Gal
    4 years ago

    Howdy all fellows sufferers! Go see dr Brahman Guyuron in beachwood Ohio. He has cured my migraines 99% after 2 surgeries. I suffered severe migraine with aura for 14 years. Surgery one helped about 70%, surgery 2 helped the other 29%! No kidding. I had almost given up trying before I found him. Good luck.

  • Luna
    4 years ago

    Individuals whose migraines are unresponsive to standard medical or pharmacological therapy or lifestyle modifications may be interested in surgical intervention.
    In year 2000, Dr. Guyuron pioneered the surgical treatment of migraines through a procedure called nerve decompression surgery (migraine surgery). As the leading authority on migraine surgery …. http://drbahmanguyuron.com/procedures/migraine-surgery-cleveland/

  • Jill M.
    4 years ago

    What kind of surgery did you have?

  • Jacqui Gallo
    4 years ago

    In my family, we all refer to it as migraine brain. The flakiness that comes along, before or after a migraine. Its nice to know they are researching that aspect of a migraine.

  • KatherineO
    4 years ago

    One day this past semester, I was in the middle of my mass media class, and all of a sudden I couldn’t remember how to spell William Randolph Hearst’s last name. I was standing there at the blackboard, chalk in hand, and wrote “Hirst,” looked at it, knew it was wrong, and couldn’t get it right. I dismissed the class saying I was feeling it, but afraid I might be having a stroke. By the time I got back to my office, which was just down the hall, the migraine had me. I took a sumatriptan and in half an hour was fine, but it truly scared me.

  • Erin Nordaby
    4 years ago

    I completely agree that pain and Cognitive Dysfunction do not go together for I Silent Migraines and horrible Brain fog/Cognitive Dysfunction during. The two times I have gone to the hospital, my Cognitive Dysfunction was so bad, my husband thought my Migraine had turned into a Stroke. Even between episodes, I feel like I am in a fog much of the time. I am happy to hear that there is hope to reverse this. For some days I just feel useless and figured this was it. Now I can hope for a better future.

  • Roz
    4 years ago

    I wanted to comment, so after 4 tries to get logged in I finally gave up and got a new password. So here I am.
    The symptoms are accurate to describe me. I also find difficulty in holding a pen to write anything down. I am finding the older I get the harder it is. I am more aware of mistakes in my job. Accounting and data entry. I have to re-type often. Luckily, I have caught most of my errors. As a precaution with my job I have developed several check and balances and I use spell check ALOT.

  • Andrea
    4 years ago

    It’s good to hear the damage from our migraine related cognitive dysfunction is reversible and there is a drug that will help with this (talking to my doctor about it next visit). But I have fears of early onset Alzheimer’s because of my migraines. I haven’t found any solid research to dismiss/support my fears but it makes me wonder why this Alzheimer drug works for some with migraines. Are the two related? So many of us have other “issues” along with our migraines. Please tell me Alzheimer’s isn’t the next “issue” I will have.

  • Tanya
    4 years ago

    Thank you sooooo much for this article. You’ve lifted a huge weight off my aching shoulders. I go from fairly intelligent to frustrated idiot in about 14 seconds. Like someone else said, I was very worried about it being dementia. That runs in my family and I could just see it permanently taking my mind. This article relieves this constant added stress. Thank you again.

  • Jill M.
    4 years ago

    I very much have this problem as well! Being in a chronic cycle, sometimes I feel so ‘stupid’ I just want to cry! I, too, feel that migraine has attacked my identity, eroding my intelligence to a much lesser level. Its so difficult not only trying to work but also to just maintain my daily life and relationships. With as much difficulty as I sometimes have, I occasionally worry that I’m in the early stages of dementia. During my better days, I do feel smarter and realize that what I’m experiencing is most likely due to just being in a non-stop cycle of migraine attacks. I wish everyone well…may you have more good days than not!

  • Jill M.
    4 years ago

    I am also taking Neuronton (300 twice daily) in addition to the Namenda XR. I still am having some migraine attacks, but what I have now I can live with as they are much less severe and less frequent. Starting to feel “normal” again. I’m also finding that they are responding to treatment faster (Maxalt ODT & Aleve), so the length of the attacks have become shorter as well. I just hope this trend continues….

  • mmjardel
    4 years ago

    I have been on Namenda for about a year. It definitely helped me with cognitive issues- didn’t make them disappear but helped. It did nothing for either severity or frequency of pain.

  • BethBlue
    4 years ago

    I definitely believe that your neurologist is on to something. Has anyone else’s physician prescribed this med? It certainly makes sense to me…if not for the migraines, at least for the loss of cognitive ability. I would give anything to restore some brain cells!

  • Jill M.
    4 years ago

    I forgot to mention (how ironic!!) that my neurologist just put me on a new preventative … Namenda XR. It’s an Alzheimer med. I’ve only been on it for about 6 weeks, but I have seen improvement with my migraines – both frequency and intensity. Yay! I’m hoping it will help improve my cognitive difficulties as well. 🙂 She said a lot of that was probably due to Zonegran, which I’ve discontinued, so we’ll see.

  • Beth
    4 years ago

    Thank you for bringing this to light!! Part of the reason I lost my job was because I was making simple stupid mistakes. I realize now that it’s part of my migraines. I’m having trouble finding the right words to say because of this. I’m just happy to know I’m not going crazy.

  • BethBlue
    4 years ago

    Imagine suffering from cognitive dysfunction and trying to teach history and social studies. Yes, that was me — and I emphasize “was.” I walked away from the career I loved because of the increasing frequency of attacks, and I found myself struggling to remember facts that should have been simple for me. “You know, that guy…he was short? Had a big hat? Put his hand under his coat? Napoleon! That’s right!”

  • msruff
    4 years ago

    Complete brain fog, lasting from the prodrome through the postdrome and not necessarily related to the level of pain. In fact, I’ve noticed it’s worst when I’m at a relatively low level of pain. My job depends on my ability to think clearly at all times, which makes this very problematic. Not that I wish anyone else to suffer, but I’m glad I’m not alone in this.

  • AmandaBerlin
    4 years ago

    I’m in the same boat as you. I work in academia and this issue only started for me a few months ago. I feel very stupid, like I can’t remember simple things about the subject I’ve spent countless years studying and researching, and I’m petrified that it will happen during a conference or workshop talk.

  • Breenmck
    4 years ago

    Although I don’t get pain, I’ve been told by my GP that I do suffer from a form of migraine. My symptoms, which are only occasional, are that I get a swirling effect in the peripheral of my vision. When that happens I seem to suffer from the cognitive dysfunction mentioned in this article. I find that if I’m reading something when these attacks occur, I find it difficult to concentrate, often find myself re-reading the same sentence time after time trying to make sense of it and just basically not taking in what I’m reading. It can be most disconcerting. However, I’m probably suffering a quite mild form of migraine, because I find that a half hour or so of sleep in a darkened room sorts it out.

  • Anne
    4 years ago

    I definitely have this – it’s like someone poured water on a circuit board. During an attack, I can’t remember my address, have a hard time spelling words, get lost while driving and can’t remember people I know really well’s names. For me, it doesn’t correspond with pain intensity – it’s more that my brain is overloaded then just shuts down.

  • KaciMo
    4 years ago

    Thanks for sharing your experience, Kerrie. My intelligence has always been a large part of my identity, and 11 years of daily migraine has robbed me of that. I have to repeat mantras to myself like the one from The Help: “You is kind. You is smart. You is important.” But it’s nice to hear that normal cognitive function returns once you have breaks between attacks. I’m praying for that day!

    –Kaci

  • Luna
    4 years ago

    Thank you for this article. I often have cognitive dysfunction without the pain along with things like light sensitivity, mild balance issues, stiff neck, fatigue, depression, etc. Not all of these at once but mix and match.

    I have a ? that I hope is appropriate here. I am wondering about the truth of the following statement. Is this really substantiated by the latest research?
    “Migraineurs have multiple connections among the sensory neurons in the brain—much more than in the brain of those without migraine.”

  • Lisa Robin Benson moderator
    4 years ago

    Hi Kerrie,
    I so relate to this as well! This symptom can be one of the most bothersome to me, because it attacks my identity. Luckily some art I can do with cognitive dysfunction, but things involving words or quick thinking are so much harder. Thanks for bringing more awareness to this issue.

    Lisa

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