[30F] With numbness, chronic joint pain, and vision issues

Patient Description

A 30-year-old female presents with numbness in the arms and legs that started in one hand about a year ago and has gradually spread to the midback. The numbness begins as tingling and can progress to a total loss of sensation, which is somewhat relieved by compression. The patient experiences chronic joint pain, frequent joint dislocations, and occasional blurriness in the left eye that clears up after a minute or two, which has occurred four times this month. Additional symptoms include headaches, a persistent cough, frequent recurrent infections, poor sleep, and fatigue. Despite these symptoms, all lab results have returned normal. An MRI of the spine revealed a bulging disk, but the orthopedic specialist indicated that it does not explain the numbness and would typically cause hand or arm pain if it were the issue. The patient also reports occasional dropping of objects without apparent cause.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Numbness in Arms and Legs, Chronic Joint Pain, and Frequent Joint Dislocation

  • Ehlers-Danlos Syndrome (EDS): This is a group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. Symptoms can include joint hypermobility, frequent joint dislocations, chronic pain, and numbness due to nerve compression.
  • Peripheral Neuropathy: This condition involves damage to the peripheral nerves and can cause numbness, tingling, and pain in the arms and legs. It can be caused by various factors, including diabetes, infections, and autoimmune diseases.

Occasional Blurriness in Left Eye

  • Optic Neuritis: This is an inflammation of the optic nerve that can cause temporary vision loss or blurriness. It is often associated with multiple sclerosis (MS) but can occur independently.
  • Transient Ischemic Attack (TIA): Sometimes referred to as a "mini-stroke," a TIA can cause temporary vision changes, including blurriness or loss of vision in one eye.

Headaches and Cough That Won't Go Away

  • Chronic Sinusitis: This condition can cause persistent headaches and a chronic cough due to post-nasal drip.
  • Allergies or Asthma: These can also cause a chronic cough and may be associated with headaches due to sinus pressure.

Frequent Recurrent Infections, Poor Sleep, and Fatigue

  • Immune System Disorders: Conditions like common variable immunodeficiency (CVID) can lead to frequent infections, fatigue, and poor sleep.
  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that doesn't improve with rest and can be accompanied by sleep disturbances and frequent infections.

What you can do

Numbness in Arms and Legs

  • See a Neurologist: Given the progression and severity of your symptoms, it's important to consult a neurologist for a thorough evaluation. They may recommend nerve conduction studies or additional imaging.
  • Physical Therapy: A physical therapist can help you with exercises to improve strength and mobility, which may alleviate some of your symptoms.

Blurriness in Left Eye

  • See an Ophthalmologist: An eye specialist can perform a detailed examination to determine the cause of your vision changes. They may recommend imaging studies like an MRI or CT scan.
  • Monitor Symptoms: Keep a journal of when these episodes occur, how long they last, and any associated symptoms. This information can be valuable for your healthcare provider.

Chronic Pain and Joint Dislocation

  • Rheumatologist Consultation: A rheumatologist can evaluate you for conditions like Ehlers-Danlos Syndrome or other connective tissue disorders.
  • Joint Protection: Use braces or supports to stabilize your joints and prevent dislocations. Avoid activities that put excessive strain on your joints.

Chronic Cough and Headaches

  • Allergy Testing: Consider seeing an allergist to rule out allergies as a cause of your chronic cough.
  • ENT Specialist: An ear, nose, and throat specialist can evaluate you for chronic sinusitis or other conditions that might be causing your symptoms.

Frequent Infections, Poor Sleep, and Fatigue

  • Immunologist Consultation: An immunologist can perform tests to evaluate your immune system function and recommend appropriate treatments.
  • Sleep Hygiene: Practice good sleep hygiene by maintaining a regular sleep schedule, creating a restful environment, and avoiding stimulants before bedtime.

What you should look out for

Given the complexity and severity of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Sudden Vision Loss: If you experience sudden or complete vision loss, seek emergency medical attention.
  • Severe Weakness or Paralysis: If you develop severe weakness or paralysis in any part of your body, go to the emergency room immediately.
  • Severe or Unexplained Pain: If you experience severe or unexplained pain, especially if it is accompanied by other symptoms like fever or swelling, seek medical attention.

Remember, while I can provide information and suggestions, it's crucial to consult with real healthcare professionals for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago


People Also Ask


What could be causing the numbness and tingling in my arms and legs?

The numbness and tingling in your arms and legs could be due to conditions like Ehlers-Danlos Syndrome, which affects connective tissues, or peripheral neuropathy, which involves damage to the peripheral nerves. Consulting a neurologist for further evaluation is recommended.


Why am I experiencing occasional blurriness in one eye?

Occasional blurriness in one eye could be caused by optic neuritis, an inflammation of the optic nerve, or a transient ischemic attack (TIA), which is a temporary disruption of blood flow to the brain. An ophthalmologist can help determine the cause.


What might be the reason for my frequent joint dislocations and chronic joint pain?

Frequent joint dislocations and chronic joint pain may be symptoms of Ehlers-Danlos Syndrome, a connective tissue disorder that leads to joint hypermobility. A rheumatologist can evaluate you for this and other similar conditions.


Why do I have frequent infections and feel constantly fatigued despite normal lab results?

Frequent infections and constant fatigue, despite normal lab results, could be due to immune system disorders like common variable immunodeficiency or chronic fatigue syndrome. An immunologist can perform tests to assess your immune function and provide guidance.


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