[29F] Experiencing multisystem symptoms for months

Patient Description

A 29-year-old female has been feeling unwell for several months, reporting symptoms that include constant sweaty palms, severe lightheadedness (rated 9/10) with a feeling of imminent fainting, weakness, muscle soreness, neck and upper back pain (rated 5/6 and 8/10 respectively), and numbness in the arms and sometimes legs. The lightheadedness is particularly severe upon waking and can last all day with brief moments of relief. The patient describes the weakness as flu-like without the presence of an actual flu and reports that the muscle soreness is not localized to any specific area. Additionally, the patient has a spinal cyst in the upper back, which causes sharp pain when lying on it and dull pain otherwise. No recent injuries or accidents were reported that could explain the weakness or soreness. The patient's symptoms are debilitating and significantly impact her ability to concentrate and perform daily activities.

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Arora's Assessment

What might be happening

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

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. Other symptoms can include weakness, muscle pain, and lightheadedness.

    • There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress.

    • There is no cure for fibromyalgia, but medication, exercise, stress management and healthy habits may ease symptoms.
  • Anxiety Disorders: These are a group of mental disorders characterized by significant feelings of anxiety and fear. Symptoms may include excessive sweating, palpitations, shortness of breath, and numbness or tingling.

    • Treatment includes counseling or medications, including antidepressants, sedatives, and sometimes beta-blockers.
  • Hyperhidrosis: This condition involves excessive sweating that's not necessarily related to heat or exercise. You may sweat so much that it soaks through your clothes or drips off your hands.

    • Treatments include prescription antiperspirant, medications, nerve-blocking medications, and sometimes surgery.

What you can do

  1. Consult a healthcare professional: It's important to discuss your symptoms with a healthcare provider. They can help determine the underlying cause and suggest appropriate treatment options.

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

  3. Practice good sleep hygiene: This includes maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding stimulating activities before bedtime.

  4. Stay hydrated: Drink plenty of fluids throughout the day, especially if you're experiencing excessive sweating.

  5. Regular exercise: Gentle exercises like walking or swimming can help improve general well-being and reduce fatigue.

What you should look out for

You should seek immediate medical attention if you experience:

  • Severe pain or discomfort
  • Trouble breathing or shortness of breath
  • Fainting or loss of consciousness
  • Severe or worsening reaction to heat
  • Symptoms that interfere with your daily activities or cause you distress

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include extreme fatigue that doesn't improve with rest, muscle pain, joint pain without swelling, headaches, sore throat, and cognitive difficulties such as memory problems or difficulty concentrating.


How is fibromyalgia diagnosed and managed?

Fibromyalgia is diagnosed based on a history of widespread pain lasting more than three months and the presence of other symptoms such as fatigue, sleep disturbances, and cognitive difficulties. Management includes medications like pain relievers and antidepressants, physical therapy, exercise, stress management techniques, and lifestyle changes.


What are the treatment options for anxiety disorders?

Treatment options for anxiety disorders include psychotherapy, such as cognitive-behavioral therapy (CBT), medications like antidepressants and anti-anxiety drugs, lifestyle changes, and stress management techniques. In some cases, beta-blockers may be used to manage physical symptoms of anxiety.


What causes hyperhidrosis and how can it be treated?

Hyperhidrosis is caused by overactive sweat glands and can be triggered by stress, heat, or no apparent reason. Treatment options include prescription antiperspirants, oral medications, Botox injections, iontophoresis, and in severe cases, surgery to remove sweat glands or cut nerves that trigger sweating.


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