[23M] Experiencing a range of new-onset symptoms including insomnia and strabismus

Patient Description

A 23-year-old male reports experiencing a new onset of various symptoms including insomnia, apathy, strabismus, depression, loss of appetite, muscle weakness, and cognitive impairment. These symptoms have been present for a couple of days. The patient has also been having vivid dreams that do not have a common theme but evoke intense feelings, contributing to a lack of restfulness upon waking. There is no reported improvement with any measures taken. The patient also notes recent weight loss and has been diagnosed with GERD in the past, but the exact timeline of diagnosis is unclear. No current medications are being taken, and there is no known family history of mental health disorders. The patient denies any use of recreational drugs, alcohol, or unprescribed medications, and there are no known drug allergies. The strabismus, which is a new symptom, occurs when the patient focuses on something and coincides with the onset of the other symptoms.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Depression: You have reported feelings of apathy, sadness, and anxiety, as well as insomnia, loss of appetite, and weight loss. These are all common symptoms of depression. Cognitive impairment can also occur in depression due to the impact of the illness on concentration and memory.

    • Treatment typically involves a combination of medication and psychotherapy. Lifestyle changes, such as regular physical activity, a healthy diet, and adequate sleep, can also help manage symptoms.
  • Neurological Conditions: The sudden onset of strabismus (misalignment of the eyes) and muscle weakness could indicate a problem with the nerves that control the eye muscles or a broader neurological issue. Conditions such as myasthenia gravis, multiple sclerosis, or a brain tumor could potentially cause these symptoms.

    • Diagnosis typically involves a neurological examination, imaging studies (like an MRI), and possibly other tests. Treatment depends on the specific condition and may involve medication, physical therapy, or surgery.
  • Sleep Disorders: Vivid dreams and feeling unrested could be signs of a sleep disorder, such as narcolepsy or REM sleep behavior disorder.

    • Diagnosis typically involves a sleep study. Treatment may involve medication and good sleep hygiene practices.

Please note that these are potential explanations based on the information provided and are not a definitive diagnosis. It's important to seek care from a healthcare professional for a formal diagnosis and treatment.

What you can do

  1. Seek immediate medical attention: The sudden onset of strabismus and muscle weakness is concerning and warrants immediate medical evaluation. These could be signs of a serious neurological condition.

  2. Consult a mental health professional: If you're feeling depressed, it's important to talk to a healthcare provider who can provide support and discuss treatment options.

  3. Practice good sleep hygiene: This includes maintaining a regular sleep schedule, creating a restful environment, and avoiding caffeine and electronics close to bedtime.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden, severe headache
  • Difficulty speaking or understanding speech
  • Sudden numbness or weakness, especially on one side of the body
  • Sudden loss of balance or coordination
  • Sudden severe eye pain or vision changes

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago


People Also Ask


What are the common symptoms of depression in young adults?

Common symptoms of depression in young adults include persistent sadness, apathy, anxiety, insomnia, loss of appetite, weight loss, and cognitive impairment such as difficulty concentrating or remembering things.


How can strabismus suddenly develop in an adult?

Strabismus can suddenly develop in adults due to neurological conditions affecting the nerves or muscles controlling eye movement, such as myasthenia gravis, multiple sclerosis, or a brain tumor. It is important to seek medical evaluation for a proper diagnosis.


What are some potential causes of vivid dreams and feeling unrested?

Vivid dreams and feeling unrested can be caused by sleep disorders such as narcolepsy or REM sleep behavior disorder. Stress, anxiety, and certain medications can also contribute to these symptoms.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes that can help manage GERD symptoms include eating smaller meals, avoiding foods and drinks that trigger reflux (such as spicy foods, caffeine, and alcohol), not lying down immediately after eating, maintaining a healthy weight, and elevating the head of the bed.

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