[42F] Experiencing severe fatigue and neurological symptoms

Patient Description

A 42-year-old female has been experiencing severe fatigue for the past year, occurring almost every day, lasting a couple of weeks, and then returning. The fatigue is rated as 10 out of 10 in severity and comes without specific triggers, significantly impacting daily activities. Additionally, she has been dealing with balance problems for over a year without any head or inner ear injuries. She reports blurred vision, particularly worse in her left eye, which has been getting blurrier over the past three weeks. The patient also experiences numbness or tingling in her face, arms, legs, hands, and feet, mostly on the left side, along with muscle weakness and difficulty walking. An electronic-like shock feeling runs from her jaw and left side of her body with certain movements or coughing, which started about three weeks ago. Her medical history includes seborrheic dermatitis, anxiety, acid reflux disease, brain fog, stiff body, memory problems, balance issues, and sweaty hands and feet. She is allergic to Oxycotten and is not currently on any medications, having stopped Zoloft some time ago.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Multiple Sclerosis (MS): MS is a chronic condition that affects the central nervous system, including the brain and spinal cord. It can cause a wide range of symptoms, including fatigue, balance problems, blurred vision, numbness or tingling, muscle weakness, and electric shock sensations (often referred to as Lhermitte's sign). MS is typically diagnosed through a combination of clinical evaluation, MRI scans, and sometimes a lumbar puncture.

    • Treatment: MS is managed with disease-modifying therapies to reduce the frequency and severity of relapses, as well as symptomatic treatments to manage specific symptoms like fatigue, muscle weakness, and pain.
  • Peripheral Neuropathy: This condition involves damage to the peripheral nerves and can cause symptoms such as numbness, tingling, and muscle weakness. It can be caused by various factors, including diabetes, infections, and autoimmune diseases.

    • Treatment: Treatment focuses on managing the underlying cause and alleviating symptoms through medications, physical therapy, and lifestyle changes.
  • Chronic Fatigue Syndrome (CFS): CFS is characterized by severe, persistent fatigue that is not improved by rest and is often accompanied by other symptoms such as muscle pain, memory problems, and headaches.

    • Treatment: There is no specific cure for CFS, but treatment focuses on symptom management, including medications, cognitive behavioral therapy, and graded exercise therapy.
  • Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It can also cause cognitive difficulties, often referred to as "fibro fog."

    • Treatment: Treatment typically includes medications, physical therapy, and lifestyle changes to manage pain and improve quality of life.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Consult a Doctor: Schedule an appointment with a neurologist or your primary care physician to discuss your symptoms in detail. They may recommend tests such as MRI scans or blood tests to help diagnose the underlying cause.
  2. Keep a Symptom Journal: Use MDandMe to journal your symptoms, track their progress, and note any potential triggers. This information can be valuable for your healthcare provider.
  3. Stay Active: Engage in gentle physical activities like walking or stretching to help maintain muscle strength and improve balance. However, avoid overexertion.
  4. Manage Stress: Practice stress-reducing techniques such as mindfulness, meditation, or yoga to help manage anxiety and improve overall well-being.
  5. Healthy Diet: Maintain a balanced diet rich in fruits, vegetables, lean proteins, and whole grains to support your overall health.
  6. Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and support your body's functions.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Sudden worsening of symptoms or new symptoms
  • Severe vision problems or loss of vision
  • Difficulty breathing or swallowing
  • Severe muscle weakness or paralysis
  • Uncontrollable pain or discomfort

Remember, while I can provide information and suggestions, it's essential to consult a healthcare professional for a formal diagnosis and appropriate treatment. If you have any further questions or need additional support, feel free to reach out.

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4 mo ago

People Also Ask


What are the common symptoms of Multiple Sclerosis (MS)?

Common symptoms of Multiple Sclerosis (MS) include fatigue, balance problems, blurred vision, numbness or tingling, muscle weakness, and electric shock sensations known as Lhermitte's sign. These symptoms can vary widely among individuals.


How is Chronic Fatigue Syndrome (CFS) diagnosed?

Chronic Fatigue Syndrome (CFS) is diagnosed primarily through a process of exclusion, as there is no specific test for it. Doctors typically rule out other conditions with similar symptoms and may use criteria such as persistent fatigue lasting more than six months, along with other symptoms like muscle pain and memory problems.


What lifestyle changes can help manage fibromyalgia symptoms?

Lifestyle changes that can help manage fibromyalgia symptoms include regular physical activity, stress management techniques like yoga or meditation, maintaining a healthy diet, and ensuring adequate sleep. These changes can help reduce pain and improve quality of life.


What are the potential causes of peripheral neuropathy?

Peripheral neuropathy can be caused by a variety of factors, including diabetes, infections, autoimmune diseases, vitamin deficiencies, and exposure to toxins. Identifying and managing the underlying cause is crucial for treatment.


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