[33F] Experiencing neurological and systemic symptoms

Patient Description

A 33-year-old female reports a range of symptoms including difficulty finding words, forgetting, repeating questions, misspelling words, and halting speech. She experiences dizziness, balance issues, a falling sensation, and lightheadedness. The patient has high blood pressure and tingling sensations with purple/blue toes. She notes temperature intolerance, night sweats, muscle spasms, nausea, bloating, and acid reflux. Additionally, there is a red rash-like burning sensation on her cheeks, heart palpitations, and extremely dry skin, particularly on the face. Her scalp psoriasis has worsened. She reports dryness in ears, nose, mouth, eyes, and throat, with narrowed nasal passages. There is sensitivity to touch, swaying/rocking when still, frequent nighttime urination, loss of appetite, restless sleep, and vision issues like blurring and difficulty focusing. Symptoms of restless sleep have been present since her teenage years, worsening since 2022, with daily occurrences noted since early 2023. No family history of neurological disorders, autoimmune diseases, or metabolic conditions is known. No recent travel or exposure to new environments or substances. Current medications include Low-ogestrel-28, Dexmethylphenidate, Cyanocobalamin, Gabapentin, Venlafaxine HCL ER, Metoprolol, and Vitamin D. No known allergies.

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Arora's Assessment

What might be happening

Your symptoms could be related to several underlying issues. Here are some possibilities:

  1. Autoimmune Disorders: Conditions like lupus or Sjögren's syndrome can cause dry skin, dry eyes, joint pain, and fatigue. They may also lead to neurological symptoms like memory issues and tingling sensations.

  2. Neurological Conditions: Multiple sclerosis or other neurological disorders could explain your memory problems, balance issues, and tingling sensations. These conditions often require imaging tests like an MRI for diagnosis.

  3. Thyroid Disorders: Hypothyroidism can cause fatigue, dry skin, hair thinning, and temperature intolerance. Blood tests can help diagnose this condition.

  4. Circulatory Issues: Raynaud's phenomenon or other vascular conditions might explain the purple/blue toes and tingling sensations. These can be triggered by temperature changes or stress.

  5. Sleep Disorders: Conditions like sleep apnea or restless leg syndrome could contribute to your restless sleep and fatigue. A sleep study might be helpful.

What you can do

Restless Sleep and Temperature Intolerance:

  • Maintain a regular sleep schedule and create a comfortable sleep environment.
  • Avoid caffeine and electronics before bed.
  • Consider using a fan or adjusting bedding to help with temperature regulation.

Memory and Cognitive Issues:

  • Keep a journal to track symptoms and any triggers.
  • Engage in brain exercises like puzzles or memory games.
  • Discuss these symptoms with a healthcare provider for further evaluation.

Dry Skin and Psoriasis:

  • Use gentle, fragrance-free moisturizers and soaps.
  • Consider seeing a dermatologist for specialized treatments.

Balance and Dizziness:

  • Ensure your home is safe to prevent falls (e.g., remove tripping hazards).
  • Practice balance exercises, like standing on one foot, if safe to do so.

General Health:

  • Stay hydrated and maintain a balanced diet.
  • Regularly monitor your blood pressure and heart rate.

You can use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Sudden or severe worsening of symptoms
  • New or worsening neurological symptoms, like severe headaches or vision changes
  • Chest pain or difficulty breathing
  • Significant changes in skin color or sensation

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago

Top picked over-the-counter products for Tingling or Cold Sensations at the Back of Your Head

People Also Ask


What could be causing my memory and cognitive issues?

Memory and cognitive issues could be related to neurological conditions such as multiple sclerosis or autoimmune disorders like lupus. It's important to discuss these symptoms with a healthcare provider for further evaluation and possibly undergo imaging tests like an MRI.


Why are my toes turning purple or blue, and what can I do about it?

Purple or blue toes could be a sign of circulatory issues such as Raynaud's phenomenon, which can be triggered by temperature changes or stress. Keeping warm, managing stress, and consulting a healthcare provider for further evaluation are recommended.


How can I manage my dry skin and worsening psoriasis?

To manage dry skin and psoriasis, use gentle, fragrance-free moisturizers and soaps. It's also advisable to see a dermatologist for specialized treatments that can help alleviate symptoms.


What steps can I take to improve my restless sleep?

Improving restless sleep can involve maintaining a regular sleep schedule, creating a comfortable sleep environment, avoiding caffeine and electronics before bed, and possibly undergoing a sleep study to identify any underlying sleep disorders.


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