[28F] Experiencing multisystem symptoms including chronic pain

Patient Description

A 28-year-old female presents with a complex array of symptoms that have been persisting for various durations. The patient reports blurred vision with difficulty focusing and seeing auras around words for the past 3 weeks, an unusual taste and smell sensation, and numbness and tingling that starts at the scalp and radiates down the left side of the neck. Additionally, there is weakness on the left side of the body, with the patient unable to hold arms up past the shoulders for more than a few seconds without pain and weakness, which has been ongoing for approximately 3 months. The patient also suffers from chronic pain described as a sharp pain in the lower and upper ribs on the right and left sides, respectively, radiating to the back, with a severity rating of 7 out of 10, and has been persistent since August. This pain is worsened by movement and breathing. Furthermore, the patient experiences migraines on the left side, described as intense pain with sensitivity to light, sound, and smells, rated at a severity of 10 out of 10, occurring at least once a month or more for a few years. The patient also notes muscle spasms in the back and has not identified any specific injury as the cause of these symptoms.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Migraines: You've mentioned having intense headaches, sensitivity to light and sound, and experiencing auras. These are common symptoms of migraines. Migraines can sometimes be accompanied by other neurological symptoms like tingling and numbness.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks. Lifestyle changes, such as stress management and avoiding triggers, can also be beneficial.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It can also cause numbness and tingling in your hands and feet.

    • Treatment typically involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Thoracic Outlet Syndrome: This condition occurs when the blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) become compressed. This can cause pain in your shoulders and neck and numbness in your fingers.

    • Treatment usually involves physical therapy and pain relief measures. In some cases, surgery might be necessary.
  • Multiple Sclerosis: This is a potentially disabling disease of the brain and spinal cord (central nervous system). It can cause a wide range of symptoms, including pain, vision problems, imbalance, fatigue, and impaired coordination.

    • Treatment typically involves managing symptoms and slowing the progression of the disease with medications.

Please note that these are only possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may refer you to a specialist, such as a neurologist, for further evaluation.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing at the time, and what makes them better or worse. This can help your healthcare provider identify patterns and triggers.
  3. Practice good self-care. This includes getting regular exercise, eating a balanced diet, getting enough sleep, and managing stress.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or you develop new symptoms
  • You experience sudden, severe pain
  • You have difficulty breathing or chest pain
  • You have sudden vision changes or loss of vision
  • You have difficulty walking or moving your limbs
  • You experience confusion, dizziness, or loss of consciousness

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

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9 mo ago


People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines often present with intense headaches, sensitivity to light and sound, and sometimes visual disturbances known as auras. Management typically involves medications to relieve symptoms and prevent future attacks, as well as lifestyle changes like stress management and avoiding known triggers.


What is fibromyalgia and what are its typical symptoms?

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. It can also cause numbness and tingling in the extremities. Treatment usually involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.


How is thoracic outlet syndrome diagnosed and treated?

Thoracic outlet syndrome is diagnosed through a combination of physical examinations, imaging tests, and sometimes nerve conduction studies. Treatment often includes physical therapy to improve posture and relieve compression, pain management, and in some cases, surgery to relieve pressure on the affected nerves or blood vessels.


What are the early signs of multiple sclerosis and how is it managed?

Early signs of multiple sclerosis can include vision problems, numbness or tingling, muscle weakness, and issues with balance and coordination. Management focuses on slowing disease progression and managing symptoms through medications, physical therapy, and lifestyle adjustments.

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