[43F] Experiencing severe episodic symptoms including nausea, tremors, and memory loss

Patient Description

A 43-year-old female has been experiencing a complex array of symptoms including severe nausea, dizziness, full body tremors resembling Parkinsonian shakes, and significant memory issues where she struggles to recall common words or objects. These symptoms have been occurring infrequently over the past year but have intensified in frequency and severity in the past several weeks. The nausea often requires her to remain still until it passes and is followed by sensations of being hot and clammy, with episodes of severe dizziness and disorientation. Additionally, she experiences intense headaches localized above her right eye, which have been described as blinding in pain. The patient has a history of agoraphobia and anxiety, with no current use of prescription medications except for Benadryl for allergies. She is allergic to gabapentin.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities that could explain your symptoms:

  • Migraines: These are severe headaches that can cause nausea, vomiting, and sensitivity to light. They can also cause visual disturbances and dizziness. The severe pain you've described above your right eye could be consistent with migraines.

    • Treatment typically involves medications to relieve the symptoms of migraines and, in some cases, medications to prevent migraines from occurring.
  • Menopause: You mentioned experiencing hot flashes for about 5 years, which is a common symptom of menopause. The hot and clammy feeling you've described could be related to menopause.

    • Treatment typically involves hormone replacement therapy (HRT) to relieve symptoms, but lifestyle changes and certain medications can also help.
  • Anxiety Disorders: You mentioned being diagnosed with agoraphobia and anxiety in 2006. Anxiety can cause a variety of physical symptoms, including nausea, dizziness, and hot flashes. It can also cause memory problems.

    • Treatment typically involves psychotherapy, medication, or both.
  • Parkinson's Disease: This is a neurodegenerative disorder that affects movement. It can cause tremors, stiffness, and balance problems. The tremors you've described could be consistent with Parkinson's disease.

    • Treatment typically involves medications to manage the symptoms.
  • Transient Ischemic Attack (TIA) or Stroke: These are serious conditions that occur when blood flow to part of the brain is blocked or reduced. They can cause symptoms like sudden numbness or weakness, confusion, trouble speaking or understanding speech, dizziness, loss of balance, and severe headache. Your symptoms of dizziness, memory problems, and severe headache could be consistent with a TIA or stroke.

    • Treatment typically involves medications to prevent blood clots and, in some cases, surgery.

Please note that this is not a comprehensive list of all possible diagnoses. These are just some possibilities based on the symptoms you've described. It's also possible that you could have more than one of these conditions.

What you can do

Given the severity and frequency of your symptoms, it's important to seek medical attention as soon as possible. Please reach out to a healthcare professional who can evaluate your symptoms and medical history in more detail and provide a diagnosis and treatment plan.

In the meantime, try to rest and stay hydrated. Avoid triggers that seem to make your symptoms worse, if possible.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Sudden severe headache
  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination
  • Sudden severe nausea or vomiting

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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7 mo ago


People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines are characterized by severe headaches, often on one side of the head, accompanied by nausea, vomiting, and sensitivity to light and sound. Management includes medications to relieve pain and prevent future attacks, lifestyle changes, and avoiding known triggers.


How can menopause affect a woman's health and what treatments are available?

Menopause can cause symptoms such as hot flashes, night sweats, mood changes, and memory issues. Treatments include hormone replacement therapy, lifestyle modifications, and medications to manage specific symptoms.


What are the symptoms of anxiety disorders and how can they be treated?

Anxiety disorders can cause symptoms like excessive worry, restlessness, fatigue, difficulty concentrating, and physical symptoms such as nausea and dizziness. Treatment typically involves psychotherapy, medications, or a combination of both.


What are the warning signs of a stroke or TIA and what should be done if they occur?

Warning signs of a stroke or TIA include sudden numbness or weakness, especially on one side of the body, confusion, trouble speaking, vision problems, dizziness, and severe headache. Immediate medical attention is crucial, and calling emergency services is recommended.

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