[26F] Experiencing migraines, neck and shoulder pain, confusion, and numbness

Patient Description

A 26-year-old female presents with worsening migraines, neck and shoulder pain, confusion/brain fog, loss of balance, and numbness and tingling, particularly worse in the right foot and arm. The brain fog, described as difficulty finishing sentences and forgetting conversations, has been present for 2 weeks and is exacerbated by fatigue. Migraines have been a long-term issue, now presenting with aura and more severe on the right side behind the eye. The neck pain has been a chronic issue, with recent shoulder pain described as a dull sensation rated 7/10 in severity. Numbness and tingling have been occurring for 2 weeks, independent of migraines. The patient also experiences leg shaking when using stairs or after prolonged activity. Medical history includes IBS, migraines with and without aura, cluster headaches, low white blood count, and thyroid nodules, with recent diagnoses except for the migraines and headaches. No known drug allergies and no current medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible conditions include:

  • Migraine with Aura: Migraines are a type of headache characterized by severe head pain, sensitivity to light, and nausea. Migraines with aura include additional neurological symptoms that precede the headache, such as visual disturbances or tingling in the face or hands. Your report of worsening migraines and numbness and tingling could be related to this condition.

    • Treatment typically involves medications to relieve symptoms and prevent future migraines.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Your report of widespread pain, fatigue, and cognitive difficulties ("brain fog") could suggest this condition.

    • Treatment typically involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Multiple Sclerosis (MS): MS is a potentially disabling disease of the brain and spinal cord (central nervous system). Early MS symptoms include fatigue, difficulty walking, numbness and tingling, muscle spasms, difficulty with coordination and balance, and problems with thinking and memory.

    • Treatment for MS is aimed at managing symptoms and slowing the progression of the disease.
  • Thyroid Disease: You mentioned having thyroid nodules, which could potentially be affecting your thyroid function. Both hypothyroidism and hyperthyroidism can cause a variety of symptoms, including fatigue, brain fog, and muscle weakness.

    • Treatment typically involves medications to correct the level of thyroid hormone in the body.

Please note that these are possibilities based on the symptoms you've reported, and it's important to consult a healthcare provider for an accurate diagnosis.

What you can do

  1. Consult a healthcare provider: Given the variety and severity of your symptoms, it's important to seek medical attention. Your healthcare provider can perform a physical examination and order tests as necessary to determine the cause of your symptoms.

  2. Keep a symptom diary: This can help you and your healthcare provider identify patterns and triggers for your symptoms.

  3. Stay hydrated and maintain a balanced diet: This can help manage your symptoms and overall health.

  4. Regular exercise: Physical activity can help reduce some symptoms such as fatigue and brain fog.

  5. Rest and stress management: Ensure you're getting enough sleep and using techniques to manage stress, as both poor sleep and high stress can exacerbate your symptoms.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden severe headache
  • Trouble speaking or understanding speech
  • Sudden numbness or weakness, especially on one side of the body
  • Sudden loss of vision or blurred vision in one or both eyes
  • Difficulty walking or loss of balance or coordination

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare provider for a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common symptoms of migraines with aura?

Migraines with aura are characterized by severe headache pain, often on one side of the head, and can include additional neurological symptoms such as visual disturbances (flashing lights or blind spots), tingling in the face or hands, and sometimes difficulty speaking. These symptoms typically precede the headache phase.


How is fibromyalgia diagnosed and treated?

Fibromyalgia is diagnosed based on a history of widespread pain lasting more than three months, along with other symptoms such as fatigue, sleep disturbances, and cognitive difficulties. There is no specific test for fibromyalgia, so diagnosis often involves ruling out other conditions. Treatment typically includes medications for pain relief, exercise, stress management, and lifestyle changes.


What are the early signs of Multiple Sclerosis (MS)?

Early signs of Multiple Sclerosis (MS) can include fatigue, difficulty walking, numbness and tingling, muscle spasms, problems with coordination and balance, and cognitive issues such as memory problems. These symptoms can vary widely among individuals.


How can thyroid nodules affect overall health?

Thyroid nodules can affect overall health by potentially altering thyroid hormone levels, leading to conditions such as hypothyroidism or hyperthyroidism. Symptoms can include fatigue, weight changes, mood disturbances, and muscle weakness. It's important to monitor thyroid function and consult with a healthcare provider for appropriate management.


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