[34F] Experiencing tremors, fatigue, and forgetfulness

Patient Description

A 34-year-old female reports experiencing essential tremors predominantly in her arms, hands, legs, and feet, which worsen with activity and improve with rest. These symptoms have been present for approximately 6 months. Alongside tremors, the patient describes extreme fatigue, random muscle twitching, and dizziness. The tremors are noted to occur with action rather than at rest. Additionally, the patient mentions forgetfulness, including difficulty in recalling words and completing thoughts, which has been occurring for a year. The patient also experiences tingling and numb sensations in her hands, feet, and scalp, described as numbness and sometimes pins and needles, present for 6 months. Muscle twitching in the arms, face, legs, and hands has been noted for a year, with a worsening condition over the past month.

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Arora's Assessment

What might be happening

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

  • Multiple Sclerosis (MS): This is a disease of the central nervous system that disrupts the flow of information within the brain and between the brain and the body. The symptoms you've described, such as fatigue, tremors, forgetfulness, and tingling in hands and feet, can be associated with MS.

    • Diagnosis often involves a neurological exam, MRI, and sometimes a spinal fluid analysis. Treatment typically involves managing symptoms and slowing the progression of the disease with medication.
  • Parkinson's Disease: This is a neurodegenerative disorder that affects predominately dopamine-producing neurons in a specific area of the brain. Symptoms generally develop slowly over years and can include tremors, limb rigidity, and balance problems. However, Parkinson's is less likely given your age and the absence of other common symptoms like slow movement.

    • Diagnosis is typically based on medical history and a neurological examination. Treatment is usually focused on managing symptoms.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It's often triggered by a stressful event, including physical stress or emotional (psychological) stress. However, fibromyalgia wouldn't explain your tremors.

    • Diagnosis is typically made based on criteria including widespread pain for more than 3 months. There's no cure, but medication, exercise, stress management and healthy habits may help manage symptoms.

Please remember that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms in a comprehensive manner.

What you can do

  1. Schedule an appointment with your primary care physician to discuss your symptoms. They may refer you to a neurologist for further evaluation.
  2. Keep a symptom diary. This can help you and your healthcare provider understand what factors may be contributing to your symptoms.
  3. Try to maintain a balanced diet and regular exercise routine. This can help manage symptoms of fatigue and improve overall health.
  4. Practice good sleep hygiene. This can help manage symptoms of fatigue and cognitive difficulties.

What you should look out for

You should seek immediate medical attention if:

  • Your symptoms significantly worsen in a short period of time.
  • You experience new symptoms such as severe headache, difficulty speaking, loss of vision, or loss of balance.
  • You have difficulty performing daily activities due to your symptoms.
  • You feel depressed or anxious due to your symptoms. Mental health is an important part of overall health, and it's important to seek help if you're feeling this way.

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7 mo ago


People Also Ask


What are essential tremors and how do they differ from other types of tremors?

Essential tremors are a neurological disorder that causes involuntary and rhythmic shaking, often in the hands, arms, head, voice, or legs. They typically occur during movement or when holding a position, unlike resting tremors seen in conditions like Parkinson's disease.


What are the common symptoms of Multiple Sclerosis (MS) and how is it diagnosed?

Multiple Sclerosis (MS) is characterized by symptoms such as fatigue, numbness, tingling, muscle weakness, and cognitive issues. Diagnosis usually involves a neurological exam, MRI scans to look for lesions in the brain and spinal cord, and sometimes a spinal fluid analysis.


Can fatigue and cognitive issues like forgetfulness be related to neurological conditions?

Yes, fatigue and cognitive issues like forgetfulness can be related to neurological conditions such as Multiple Sclerosis or other disorders affecting the central nervous system. These symptoms occur due to disruptions in nerve signal transmission.


What should I do if I experience worsening symptoms or new neurological symptoms?

If you experience worsening symptoms or new neurological symptoms such as severe headache, difficulty speaking, or loss of vision, you should seek immediate medical attention. It's important to consult with a healthcare professional for a thorough evaluation and appropriate management.

2 Comments


Owner

Anonymous#13318

7 mo ago

Ive gone through like every blood test. Tested positive for ANA, first titer was 1:40, second was 1:80, positive antiDna. They checked me for all the rheumatology diseases, those were normal. Just checked my iron. I'm iron deficient without Anemia. I asked to be referred to neurology but they keep brushing it off. Yes I have eye pain when I look around, every year my prescription gets worse. I'm legally blind without glasses. one eye is worse. I'm just incredibly frustrated because I am miserable and it's getting harder to do normal every day things, but they keep saying "let's run more blood tests"

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Billy#7

7 mo ago

As a young woman multiple sclerosis (MS) would be at the top of the differential. Have you ever had any eye pain or visual disturbance, especially localized to one eye? There are good symptomatic relief and disease-modifying therapies (DMTs) for MS if that's what it turns out it is. Have you gotten a diagnosis?

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