[25F] Experiencing neurological and cardiovascular symptoms

Patient Description

A 25-year-old female presents with a constellation of symptoms including persistent head pressure, particularly in the left temple, accompanied by lightheadedness and dizziness persisting for two weeks. She reports a weakness so severe that it limits her daily activities after one to two hours, and a constant ringing in her ears that worsens with external noise. The patient experiences tachycardia with heart rates between 112-150 bpm at rest, sudden and intense hot flashes, and confusion leading to disorientation and speech difficulties. Migraines with aura manifest as changes in vision and hearing, with blurry vision and severe headaches. She also experiences slurred speech and more pronounced weakness on the left side of her body, alongside hand tremors. The patient has a history of epilepsy and Postural Orthostatic Tachycardia Syndrome (POTS), diagnosed at age 14, and is not currently on any medications with no known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possible conditions:

  • Migraine: Migraines are severe headaches that can cause symptoms like those you're experiencing, including head pressure, dizziness, visual disturbances (aura), and difficulty speaking. Migraines can also cause nausea and sensitivity to light and sound.

    • Treatment for migraines can include over-the-counter pain relievers, prescription medications, and lifestyle changes to help manage stress and avoid migraine triggers.
  • Postural Orthostatic Tachycardia Syndrome (POTS): This is a condition that affects circulation (blood flow). It involves the autonomic nervous system and sympathetic nervous system. Symptoms can include tachycardia, lightheadedness, fainting, and rapid heartbeat.

    • Treatment for POTS can include increasing fluid and salt intake, wearing compression stockings, and taking medications to manage symptoms.
  • Epilepsy: This is a neurological disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Your symptoms of confusion, trouble speaking, and hand tremors could be related to this condition.

    • Treatment for epilepsy generally involves taking medications to control seizures. In some cases, surgery or vagus nerve stimulation may be recommended.
  • Meniere's disease: This is a disorder of the inner ear that can lead to dizziness and a ringing sound in the ears. It's often associated with fluctuating hearing loss and sometimes a feeling of pressure or pain in the affected ear.

    • Treatment for Meniere's disease can include dietary changes, medications, and in some cases, surgery.
  • Anxiety Disorder: Anxiety can cause a variety of physical symptoms, including dizziness, rapid heartbeat, and hot flashes. It can also cause difficulty concentrating and feeling as though you're "not real" or "detached" from yourself.

    • Treatment for anxiety disorders can include psychotherapy (talk therapy), cognitive behavioral therapy, medications, and lifestyle changes to manage stress.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

Given the severity and number of symptoms you're experiencing, it's important to seek medical attention as soon as possible.

  1. Schedule an appointment with your primary care doctor. They can conduct a physical examination and order tests to help determine what's causing your symptoms.
  2. Keep a symptom diary. Note when each symptom occurs, its severity, and any potential triggers. This can be helpful information for your doctor.
  3. Stay hydrated and maintain a balanced diet. This can help manage symptoms of POTS and improve overall health.
  4. Try to get regular, moderate exercise. This can help improve circulation and reduce symptoms of POTS and anxiety.
  5. Practice stress management techniques, such as deep breathing, meditation, and yoga. These can help manage symptoms of anxiety and migraines.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or you develop new symptoms
  • You experience a seizure
  • You have a severe headache unlike any you've had before
  • You have difficulty breathing or chest pain
  • You have sudden vision changes or loss of vision
  • You have sudden speech difficulties or weakness on one side of your body

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

People Also Ask


What are the common symptoms of Postural Orthostatic Tachycardia Syndrome (POTS)?

Common symptoms of POTS include a rapid increase in heart rate when standing, lightheadedness, fainting, fatigue, and sometimes nausea or headaches. It can also cause difficulty concentrating and exercise intolerance.


How can migraines with aura affect daily life?

Migraines with aura can significantly impact daily life by causing severe headaches, visual disturbances, and sensitivity to light and sound. These symptoms can lead to missed work or social activities and may require individuals to rest in a dark, quiet room until the migraine subsides.


What are the treatment options for managing epilepsy?

Treatment options for managing epilepsy typically involve anti-seizure medications to control seizures. In some cases, surgery, vagus nerve stimulation, or dietary changes like the ketogenic diet may be recommended. It's important to work closely with a healthcare provider to find the most effective treatment plan.


Can anxiety disorders cause physical symptoms like dizziness and rapid heartbeat?

Yes, anxiety disorders can cause a range of physical symptoms, including dizziness, rapid heartbeat, sweating, and hot flashes. These symptoms are often a result of the body's 'fight or flight' response and can be managed with therapy, medication, and lifestyle changes.


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