Does Fever Make You Stupid?

[Trent Wray]

I would venture to guess that the body tends to regulate itself at a temperature where all organs can function efficiently. In different locales, the body will have to work harder to maintain that temperature, a failure to maintain that temperature certainly leads to severely degraded mental function (heat stroke, hypothermia).

Yeah I was trying to think in terms of the effects on mental status of the bodies attempts at thermoregulation within a range, and if the lower end of that acceptable range (like say, 95 F) had an effect before failure to regulate gave way to hypothermia and altered mental status came as a secondary aspect. But after thinking about it .... when the body is exposed to cold, blood flow is diverted from the extremities to the core (in general), and this would include the head .

I remember once I was working at a lobster pound in Connecticut during winter, and I had a 103 fever while working fourteen hour days doing back breaking labor. During an early morning rush when I had to hop on a fork lift, I began to hallucinate and came close to driving the forklift off a dock right into the ocean. Later that day I made a mistake and fell waste deep into a tank of below freezing water and I remember shaking for over an hour, with a fever, in the winter, sitting next to furnace to dry out, trying not to hallucinate and see things moving around me that weren't really there moving LOL. I was always curious what the effect of the inner fever with the outer freezing weather and the constant in/out from warm environment to freezing environment played in all that combination.

 

[Robin]

I have come to learn over the years that when I get a fever, I get stupid. For years I have written programming code and plain old English as a major part of my work. As such I have had had the opportunity to review my programming and writing after having written it while having a fever. Invariably I do stupid things that I would not ordinarily do. For example, I write code that clearly doesn't do what it's supposed to do, and after the fact I cannot figure out how I possibly thought it would work. With English I'll make errors in grammar and substitute phonetically similar words. For example, I might write "Monday" instead of "muddy day."

I'm also somewhat meticulous about where I place things. I've never in my 44 years lost a wallet or keys. I almost never have to look for my shoes or gear I need (musical, photography, sports) because I always put them back in the same place or two. When I have a fever I do odd things like set my keys down on a table rather than the one spot I always keep them.

Anybody else have similar experiences?

I recently had a reasonably bad fever. I was sitting on the couch watching Key Largo. The phone rings and it is work, saying the comms link between one of our servers and an external customer is down. I say "oh well, with a storm like this that isn't surprising".

 

[RussDill]

Yeah I was trying to think in terms of the effects on mental status of the bodies attempts at thermoregulation within a range, and if the lower end of that acceptable range (like say, 95 F) had an effect before failure to regulate gave way to hypothermia and altered mental status came as a secondary aspect. But after thinking about it .... when the body is exposed to cold, blood flow is diverted from the extremities to the core (in general), and this would include the head .

I remember once I was working at a lobster pound in Connecticut during winter, and I had a 103 fever while working fourteen hour days doing back breaking labor. During an early morning rush when I had to hop on a fork lift, I began to hallucinate and came close to driving the forklift off a dock right into the ocean. Later that day I made a mistake and fell waste deep into a tank of below freezing water and I remember shaking for over an hour, with a fever, in the winter, sitting next to furnace to dry out, trying not to hallucinate and see things moving around me that weren't really there moving LOL. I was always curious what the effect of the inner fever with the outer freezing weather and the constant in/out from warm environment to freezing environment played in all that combination.

paradoxical, being immersed in extremely cold water is one of the worst things you can do for someone with heat stroke. It constricts their blood vessels that are near the surface of the skin and thus makes it more difficult for heat to escape. I'm not sure if this is also true for fever.

 

[RussDill]

What do you consider the cut-off between high and low fevers? No, it's not a trap - just curious.

For me, high would be 102F or above

 

[paximperium]

paradoxical, being immersed in extremely cold water is one of the worst things you can do for someone with heat stroke. It constricts their blood vessels that are near the surface of the skin and thus makes it more difficult for heat to escape. I'm not sure if this is also true for fever.

Uh no. We use to dunk people in tubs of ice water in the past and nowadays we strip them naked, soaks them in cold towels, place ice packs in their groin, armpits etc. Heat stroke usually means the loss of thermoregulation so the vasoconstriction is actually lost.

 

[paximperium]

What do you consider the cut-off between high and low fevers? No, it's not a trap - just curious.

End organ affects.

 

[Cainkane1]

I had a really nasty fever that ended up coming back once in the same few days. I was pretty damn delirious and had horrible nightmares when I did sleep.

A friend of mine had the flu and I helped his mother take care of him. He was seeing people that weren't there and overall while he wasn't stupid he was out of it. My suggestion is that if you're sick try not to work. You aren't on your best performance level.

 

[RussDill]

Uh no. We use to dunk people in tubs of ice water in the past and nowadays we strip them naked, soaks them in cold towels, place ice packs in their groin, armpits etc. Heat stroke usually means the loss of thermoregulation so the vasoconstriction is actually lost.

Once again, the great WP has lied to me:

However, immersion in very cold water is counterproductive, as it causes vasoconstriction in the skin and thereby prevents heat from escaping the body core.

http://en.wikipedia.org/wiki/Hyperthermia#Treatment

 

[Trent Wray]

Uh no. We use to dunk people in tubs of ice water in the past and nowadays we strip them naked, soaks them in cold towels, place ice packs in their groin, armpits etc. Heat stroke usually means the loss of thermoregulation so the vasoconstriction is actually lost.

Hey Doc Pax ---- if you know or care to answer, are there long lasting mental status effects from prolonged fever primarily? In post #7 I mention thyroid storm because of the two patients I've seen with it presented with ams long after their fever had finally been resolved, as well as some of the other aspects associated with the crisis. It's the only times I've seen someone with such high prolonged temperatures not related to environmental sources, and was always curious what the lasting impact might be for those individuals, and if the fever itself played a significant role in that.

 

[paximperium]

Hey Doc Pax ---- if you know or care to answer, are there long lasting mental status effects from prolonged fever primarily? In post #7 I mention thyroid storm because of the two patients I've seen with it presented with ams long after their fever had finally been resolved, as well as some of the other aspects associated with the crisis. It's the only times I've seen someone with such high prolonged temperatures not related to environmental sources, and was always curious what the lasting impact might be for those individuals, and if the fever itself played a significant role in that.

I've found a few very technical papers in the Journal of Applied Physiology about the change in blood flood and metabolism of the brain in active heating(external temp increase) in volunteers and some in induced fevers. It is interesting that certain parts of the brain increase their metabolism and blood flow while other have some decrease. I can't really find anything pertaining to change in actual cognitive function.

As to your question anecdotally I would say yes. The brain has a very narrow functional band and prolonged hyperthermia will undoubtedly lead to some neuronal damage. What that actual temp or specific damage is, I do not know. We do know in any patient with brain insult(lack of blood flow from cardiac arrest, stroke or trauma), any hyperthermia will lead to worst outcomes while hypothermia may(big may now, very controversial at the moment) lead to neuroprotection.

 

[Uncayimmy]

paradoxical, being immersed in extremely cold water is one of the worst things you can do for someone with heat stroke. It constricts their blood vessels that are near the surface of the skin and thus makes it more difficult for heat to escape. I'm not sure if this is also true for fever.

You have to think this one through. The part about the blood vessels is true, but that's a reaction to the body cooling. It's damage control trying to slow down the heat loss. You probably sit around your house in 78 degree air all day long, no problem. Now go stand in a swimming pool at 78 degrees. The water is going to suck out the heat from your body far faster than the air.

 

[Trent Wray]

I've found a few very technical papers in the Journal of Applied Physiology about the change in blood flood and metabolism of the brain in active heating(external temp increase) in volunteers and some in induced fevers. It is interesting that certain parts of the brain increase their metabolism and blood flow while other have some decrease. I can't really find anything pertaining to change in actual cognitive function.

As to your question anecdotally I would say yes. The brain has a very narrow functional band and prolonged hyperthermia will undoubtedly lead to some neuronal damage. What that actual temp or specific damage is, I do not know. We do know in any patient with brain insult(lack of blood flow from cardiac arrest, stroke or trauma), any hyperthermia will lead to worst outcomes while hypothermia may(big may now, very controversial at the moment) lead to neuroprotection.

I'm guessing the highlighted part is X-Files, near fringe territory to some "degree" (crappy pun )

 

[Trent Wray]

I've found a few very technical papers in the Journal of Applied Physiology about the change in blood flood and metabolism of the brain in active heating(external temp increase) in volunteers and some in induced fevers. It is interesting that certain parts of the brain increase their metabolism and blood flow while other have some decrease. I can't really find anything pertaining to change in actual cognitive function.

As to your question anecdotally I would say yes. The brain has a very narrow functional band and prolonged hyperthermia will undoubtedly lead to some neuronal damage. What that actual temp or specific damage is, I do not know. We do know in any patient with brain insult(lack of blood flow from cardiac arrest, stroke or trauma), any hyperthermia will lead to worst outcomes while hypothermia may(big may now, very controversial at the moment) lead to neuroprotection.

And after just talking with my wife (she's an RN in a caridopulmonary ICU), she says her unit is the only one in her hospital authorized to induce hypothermic states in patients with MI's. She says that basically they use cooling blankets asap, when the patient doesn't qualify for stents or other immediate interventions, etc. And she works at Parkland in Dallas,TX ... interesting.

 

[Dr. Imago]

As to your question anecdotally I would say yes. The brain has a very narrow functional band and prolonged hyperthermia will undoubtedly lead to some neuronal damage. What that actual temp or specific damage is, I do not know. We do know in any patient with brain insult(lack of blood flow from cardiac arrest, stroke or trauma), any hyperthermia will lead to worst outcomes while hypothermia may(big may now, very controversial at the moment) lead to neuroprotection.

To echo this answer (since you asked previously), I would say "I don't know." Some fever is helpful during acute infection. This has been studied, and the feeling is (generally) that a mild fever is probably a helpful physiologic process used to stave-off the infective process.

However, prolonged high fever may have prolonged deleterious effects that are hard to quantify. As an aside, we know that people with brain tumors usually have a "prodrome" of cognitive dysfunction before the diagnosis is made. This is a discrete, though, "organic" (for lack of a better term) process ongoing in the brain that subsequently explains what was usually an insidious deterioration over the course of months.

If there is a high enough and prolonged enough fever to cause significant structural impairment in the brain then, yes, probably there are prolonged enough effects to cause irreversible damage. Having said that, the brain is an incredibly "plastic" organ that is able to circumvent damaged areas by "relearning" in other parts. This is well-evidence in patients who have otherwise catastrophic cerebrovascular accidents that are eventually able to recover substantial portions of previously lost function. I tend to think of the brain as hiearchical, and not as a cohesive unit that is affected universally when there is an insult. As such, you may lose - even transiently - one area, but able to compensate for that loss by increase of function in another.

~Dr. Imago

 

[Monketi Ghost]

Our six year old had a wicked 103 fever last night. She would open her eyes, see me, and just start babbling incoherently and pushing her hands at something she wasn't actually seeing. Here eyes were glazed, and she was mixing languages.

I can remember when I was a kid having a few serious fevers and hallucinating wildly.

 

[Trent Wray]

Our six year old had a wicked 103 fever last night. She would open her eyes, see me, and just start babbling incoherently and pushing her hands at something she wasn't actually seeing. Here eyes were glazed, and she was mixing languages.

I can remember when I was a kid having a few serious fevers and hallucinating wildly.

Monkey Ghost ... I've assumed you have a fever every time you post

 

[Monketi Ghost]

...fever all through the night...

 

[Uncayimmy]

...fever all through the night...

Marcia Brady like you've never seen her before.

 

[This is The End]

I get fever dreams that are quite distinctive in nature. I'll repeatedly try to figure out some very simple (usually abstract) problem, like whether or not one shape will fit inside another shape, and be unable to come to any clear conclusion, over and over again, despite it seeming somehow very important that I figure it out....

You could not have described what happens when I get a very high* fever more perfectly. Though, sometimes it involves almost the opposite: an impossible task (for instance, thinking I have to count to a nearly infinite number..... or else!).

*Once every several years or so, not sure what exact temperature (too out of it to know what a thermometer is at the time perhaps!).

Fever nightmares are horrible... not to mention the fact that they seem to last forever. When I do eventually wake up, I will have a fairly clear memory of what was going on, and will be in disbelief that I was fussing over such a stupid and/or small matter.

 

[Miss_Kitt]

I draw a line, mentally, between a 'low fever' and a 'high fever' based upon its cognitive impacts. A low fever makes me a bit slow, inatttentive and not able to solve "Challenger" crosswords; a high fever makes me unable to remember minor details like my spouse's phone number--that actually happened!--or write coherent sentences.

I once had a really high fever, even with Tylenol it only came down into the moderate fever range; and while it was way up there, I saw really large spiders crawling on my bedroom wall. I do not like arachnids, but I was just too tired and muddled to try to get away. I know on that occasions my fever was up in the 102/103 F range; and it apparently went higher, since I later experienced the "air feels like jello it's so hard to push through it" slow motion walking. Influenza is nothing to mess with! Get your shot every year, as I now do. That was as miserable as I've ever been.

I wonder if Mythbusters could come up with a way to test the assertion that driving with a low fever is equivalent to driving after a drink or two?

Interesting topic! Thanks, MK