Chiari Malformation With ADHD - A Lot Of Cognitive Issues


Jan 13, 2015

I am an adult with ADHD, 15 months ago I had decompression surgery as I had a syrinx almost the full length of my spine and Chiari malformation. The syrinx has reduced massively but is still large. I have had many symptoms following surgery but am wanting to know if any chiari patients also have experience with ADHD as alot of the cognitive issues I am having now are similar to ADHD like lack of concentration and taking in information. From what I can find there is no official info about this so I was hoping to hear from anyone who has a personal experience of this. I don't know if I can expect to return to normal as alot of the cognitive symptoms I already had but on a much smaller scale.

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Chiari Malformation :: Reduction In CSF Flow

Opinions please, from people diagnosed with a reduced CSF flow. And from those who have had surgery because of it. Or anyone who had advice.

I am 61 years old. My Chiari is only 1.5 mm. My last MRI said I have a mild reduction in CSF flow. No syrinx.

I am finding it increasingly more difficult to concentrate and wonder if the mild reduction in CSF flow could be the reason. Or, am I just getting old? I need to make a living, yet I have so much brain fatigue and overall not feeling well, that I am not succeeding.

I am not being productive and even though I need to care, I don't have the energy to. People, like my GP, try to convince me it can't be the Chiari (though I have not talked to him yet about the reduction in CSF flow). Maybe he will change his mind. But it is to the point that I doubt my judgement, wonder if it is mostly depression or just aging.

I am not begging my doctor for pain medication so he is concluding it can't be hydrocephalus. I understand that may be so, since that would have shown on the MRI too, but can the mild lack of CSF flow be causing problems anyway? If so, how?

I have learnt to put up with headaches and don't like meds stronger than Tylenol with codeine, which doesn't work. I do not want to end up dependent on more medications. Can't afford the ones I take!

Sometimes I have the headaches and neck pain for weeks. But even when that goes away I feel in a fog, and get double vision. It is both too hard to take in information and too hard to see. I only read on the computer or iPad now. Reading print is too frustrating to be a pleasure.

I hear words but my brain is usually too slow to process it. It's scary. I keep rewinding the TV and asking people to repeat themselves. This is life changing because I don't like to socialize anymore. It's embarrassing!

Throughout my life I have had periods where I feel in a fog and periods where my head feels relatively clear. I went through times of relatively good health, but never knew what kind of a day it will be. I failed grade nine because I couldn't concentrate but later got a university degree.

So I think I am intelligent, but am afraid that with a lifetime of blocked CSF flow there is brain damage. I don't have a bad gait, urinary problems or numbness consistent with hydrocephalus, thank goodness! But I just feel that my thoughts are too slow to function the way I need to, among other symptoms.

I haven't worked outside of the home for five years now, though I do need an income. Been trying to build a career in a field which I prefer not to mention, working from home. But it takes more energy and concentration than I have and I'm being left behind, as usual.

I would like to know if I am obsessing over this Chiari thing, blaming it for my problems when it might be depression and anxiety. Should I just forget about it and leave well enough alone? Or would surgery help me get my concentration and energy back?

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I am scared of being labeled depressed and psychotic by doctors so I don't say anything. I have been dismissed by the only neurologist I have seen since my surgery, she even said I was 'cured' by the surgery. ARE these symptoms of Chiari or AM I crazy?

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Here is his medication history:

August 2011 – Vyvanse ??mg (very small amount)
September 2011 – Vyvanse 30mg (adjusted to 30 mg)
May 2012 – Trial samples of Intuniv w/ Vyvanse for two weeks. After two weeks he was out of         school and parents decided not to continue the Intuniv.

September 2013 – Intuniv 2mg w/ Vyvanse
September 2013 – Concerta 36mg (removed from Vyvanse and Intuniv because he became over-emotional and violent/aggressive)

December 2013 -  Concerta 54mg (Dr. Snyder prescribed)

March 2014 – Methylphenidate 10mg (3 times a day) (March 7th thru March 14th)
Methylphenidate 15mg (3 times a day) (started March 15th)
April 2014 – Methylphenidate 20mg (3 times a day) (started April 14th)
May 2015 – Adderall (adderall) 10mg (3 times a day) (started May 14th)
June 2015 – Adderall (adderall) 15mg (3 times a day) (started June 3rd)
August 2015 – Guanfacine 1/2mg (3 times a day) (started August 21st)

September 2015 – Methylphenidate ER 30mg (once a day) (started September 6th)

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