[49F] Experiencing severe muscle cramps and neurological symptoms

Patient Description

A 49-year-old female has been experiencing severe muscle cramps since November 2018, which have worsened over time. The cramps occur early in the morning, around noon, and in the evening, particularly if she stands for long periods. Stretching provides some relief. She also reports emotional instability for about a year, visual impairment for 8-10 years with extreme blurriness and double vision, and stuttering for 5 years. Additionally, she has had severe headaches, changes in consciousness, urinary incontinence, weakness, numbness, and significant weight loss due to decreased appetite. Her medical history includes fibromyalgia, degenerative disc disease, a blood disorder requiring infusions and transfusions, IBS colitis, urinary incontinence, stress-related seizures, low blood pressure, and heart conditions diagnosed in 2023. She is allergic to multiple medications, including penicillin and ibuprofen. Current medications include ropinirole (2 mg twice daily), simvastatin (20 or 25 mg at bedtime), and metoprolol (25 mg daily, recently reduced from 50 mg).

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Arora's Assessment

What might be happening

Based on your symptoms, you may be experiencing the following:

  • Multiple Sclerosis (MS): This is a chronic disease that affects the central nervous system, particularly the brain and spinal cord. It can cause a wide range of symptoms, including muscle weakness, difficulty with coordination and balance, pain, and fatigue. The fact that you mentioned you were told you have MS might explain many of your symptoms.

    • Treatment for MS can include medications to manage symptoms and slow the progression of the disease, physical therapy, and lifestyle modifications.
  • Fibromyalgia: This is a chronic condition characterized by widespread pain and tenderness, often accompanied by fatigue, sleep, memory and mood issues. You mentioned that you have been diagnosed with this condition, which could explain your chronic pain and emotional instability.

    • Treatment for fibromyalgia can include medications, cognitive behavioral therapy, and gentle exercise.
  • Depression: This is a mood disorder that causes persistent feelings of sadness and loss of interest. It can lead to a variety of emotional and physical problems. You mentioned emotional instability and a lack of desire to go out, which could be signs of depression.

    • Treatment for depression can include medications, psychotherapy, or both.
  • Vision problems: You mentioned having blurry vision and seeing double. This could be due to a number of conditions, including age-related eye conditions, neurological conditions, or side effects from medication.

    • Treatment will depend on the underlying cause of the vision problems.

What you can do

  1. Consult with your doctor: It's important to discuss your symptoms with your healthcare provider. They can help determine the cause of your symptoms and suggest appropriate treatment options.

  2. Manage your symptoms: Depending on the cause of your symptoms, there may be things you can do to help manage them. For example, regular exercise and a healthy diet can help manage symptoms of MS and fibromyalgia. Cognitive behavioral therapy can help manage symptoms of depression.

  3. Monitor your symptoms: Keep track of your symptoms and any changes in their severity. This can help your healthcare provider determine the effectiveness of your treatment and make any necessary adjustments.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, seek medical attention immediately.
  • If you experience severe pain, have difficulty breathing, or have changes in your vision or mental status, seek emergency medical attention.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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10 mo ago

People Also Ask


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

Common symptoms of Multiple Sclerosis (MS) include fatigue, difficulty walking, numbness or tingling, muscle weakness, vision problems, and issues with coordination and balance. Symptoms can vary widely among individuals.


How can fibromyalgia affect daily life?

Fibromyalgia can cause widespread pain, fatigue, sleep disturbances, and cognitive difficulties, often referred to as 'fibro fog.' These symptoms can significantly impact daily activities and quality of life.


What are some effective treatments for depression?

Effective treatments for depression can include medications such as antidepressants, psychotherapy (like cognitive behavioral therapy), lifestyle changes, and sometimes a combination of these approaches. It's important to work with a healthcare provider to find the best treatment plan.


What could cause blurry vision and double vision?

Blurry vision and double vision can be caused by a variety of factors, including neurological conditions like MS, eye conditions such as cataracts or glaucoma, or side effects from medications. A thorough evaluation by a healthcare provider is necessary to determine the underlying cause.


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