[52F] Experiencing dizziness, body pain, and neurological symptoms

Patient Description

A 52-year-old female presents with a 6-month history of constant dizziness, rated 7-8/10 in severity, which worsens with movement and has been occurring daily for the past 2 weeks. She experiences tingling sensations in her limbs and whole body, described as a vibrating/traveling feeling, accompanied by painful spasms that jerk her legs and body, particularly at night. The patient has been diagnosed with fibromyalgia and reports a 10-year history of body pain that intensifies at night and is exacerbated by changes in weather. She also experiences cognitive fogginess, with slowed thoughts, difficulty multitasking, and occasional word-finding difficulties and slurred speech, which have been present for 6 months to a year. Additionally, she reports motion sickness with nausea and vomiting when driving, which has worsened over the past 6 months to a year. The patient has a history of asthma, type 2 diabetes, hypothyroidism, high blood pressure, vitamin D deficiency, and vitiligo. She is allergic to sulfa drugs. No recent injuries, accidents, severe headaches, changes in vision, loss of consciousness, or slurred speech were reported. However, she does experience frequent ringing in her ears (tinnitus) and has a lack of energy and sleepiness.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Vestibular Migraines: This condition can cause severe dizziness, balance problems, and even problems with sight and hearing. These symptoms are often so severe that they affect balance. This could explain your constant feelings of being off balance and your motion sickness.

    • Treatment typically involves medications to control the migraines and lifestyle changes to avoid triggers.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. This could explain your body pain, fatigue, and cognitive difficulties (fogginess).

    • Treatment typically involves a combination of medications, exercise, stress management and healthy lifestyle habits.
  • Peripheral Neuropathy: This results from damage to your peripheral nerves, which often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. Your diabetes could put you at a higher risk for this condition. This could explain the tingling sensation and spasms you've been experiencing.

    • Treatment typically involves managing the condition causing the neuropathy and medications to relieve symptoms.

What you can do

  1. Consult with your doctor about your symptoms. They can provide a formal assessment and order relevant tests if necessary.
  2. Continue to manage your diabetes, as uncontrolled blood sugar can lead to a variety of complications, including peripheral neuropathy.
  3. Try to identify any triggers for your migraines and avoid them if possible.
  4. Regular exercise, a healthy diet, and adequate sleep can help manage symptoms of fibromyalgia and improve overall health.
  5. Over-the-counter pain relievers may help manage your body pain, but always consult with your doctor before starting any new medication.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms worsen or you develop new symptoms
  • If your pain becomes severe or unmanageable
  • If you experience any changes in vision or hearing
  • If you have difficulty controlling your blood sugar

Please remember that while I strive to provide accurate and helpful medical information, I am not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are vestibular migraines and how do they differ from regular migraines?

Vestibular migraines are a type of migraine that primarily affects balance and can cause severe dizziness, vertigo, and problems with sight and hearing. Unlike regular migraines, which are often characterized by intense headaches, vestibular migraines may not always involve a headache but focus more on balance and sensory disturbances.


How can fibromyalgia affect cognitive functions like memory and multitasking?

Fibromyalgia can affect cognitive functions through a phenomenon often referred to as 'fibro fog.' This can include symptoms like slowed thought processes, difficulty multitasking, memory issues, and problems with word-finding. These cognitive difficulties are thought to be related to the chronic pain and fatigue associated with fibromyalgia.


What is peripheral neuropathy and how is it related to diabetes?

Peripheral neuropathy is a condition resulting from damage to the peripheral nerves, leading to symptoms like weakness, numbness, and pain, typically in the hands and feet. Diabetes is a common cause of peripheral neuropathy because high blood sugar levels can damage nerves over time, leading to these symptoms.


What lifestyle changes can help manage symptoms of fibromyalgia?

Lifestyle changes that can help manage fibromyalgia symptoms include regular exercise, maintaining a healthy diet, ensuring adequate sleep, and practicing stress management techniques. These changes can help reduce pain, improve mood, and enhance overall quality of life.


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