[23F] With PNES, eye pain, chronic headaches, and sudden left arm weakness

Patient Description

Maliah Grace, a 23-year-old female, reports experiencing psychogenic non-epileptic seizures (PNES) and chronic headaches. She describes pain when moving her eyes and a sudden onset of weakness and pain in her left arm and hand, which she rates as a 6 out of 10 in severity. The weakness has been present for about a week. Maliah notes that her vision has worsened since the weakness began, but she has not experienced any difficulty with speech or understanding. She does not report any recent injuries to her arm or hand and believes the symptoms may be related to her headaches and PNES. There is no mention of a family history of stroke or neurological disorders.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, here are some possibilities:

  1. PNES (Psychogenic Non-Epileptic Seizures): PNES can sometimes be associated with physical symptoms such as headaches and muscle weakness. While PNES itself is not caused by electrical disruptions in the brain like epilepsy, it can still lead to significant physical and emotional distress.

  2. Chronic Headaches: Your chronic headaches could be contributing to the pain when moving your eyes and the weakness in your arm. Tension headaches or migraines can sometimes cause muscle weakness or pain in different parts of the body.

  3. Neurological Concerns: Given your family history of multiple sclerosis (MS) and epilepsy, it's important to consider that neurological conditions can sometimes present with symptoms like muscle weakness and vision changes. However, these conditions would require a thorough evaluation by a healthcare professional for an accurate diagnosis.

What you can do

Weakness in Arm and Hand:

  • Since the weakness came on suddenly, it's important to follow up with your healthcare provider to ensure there are no underlying neurological issues.
  • Physical therapy might be beneficial to help strengthen your arm and hand and improve function.

Chronic Headaches and Eye Pain:

  • Keep a headache diary to track the frequency, duration, and triggers of your headaches. This can help your healthcare provider tailor your treatment plan.
  • Ensure you are staying hydrated, getting enough sleep, and managing stress, as these can all impact headache frequency and severity.

General Management:

  • Continue any prescribed treatments or therapies for PNES and follow up with your healthcare provider regularly.
  • Consider using MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

  • If you experience any new or worsening symptoms, such as increased weakness, changes in vision, or difficulty speaking, seek medical attention promptly.
  • Keep an eye out for any new symptoms that could indicate a neurological issue, such as numbness, tingling, or balance problems.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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6 mo ago

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People Also Ask


What are psychogenic non-epileptic seizures (PNES) and how do they differ from epileptic seizures?

Psychogenic non-epileptic seizures (PNES) are episodes that resemble epileptic seizures but are not caused by electrical disruptions in the brain. Instead, they are often related to psychological factors. Unlike epileptic seizures, PNES do not show abnormal brain activity on an EEG.


Can chronic headaches cause muscle weakness or pain in other parts of the body?

Yes, chronic headaches, such as tension headaches or migraines, can sometimes cause muscle weakness or pain in other parts of the body. This can be due to the overall stress and tension that headaches can place on the body.


What are some potential neurological conditions that could cause sudden muscle weakness and vision changes?

Potential neurological conditions that could cause sudden muscle weakness and vision changes include multiple sclerosis (MS), stroke, or other neurological disorders. These conditions require thorough evaluation by a healthcare professional for accurate diagnosis.


How can I manage chronic headaches and eye pain effectively?

To manage chronic headaches and eye pain, it's important to keep a headache diary to identify triggers, stay hydrated, get enough sleep, and manage stress. Consulting with a healthcare provider for a tailored treatment plan is also recommended.


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