[52F] With progressive neurological symptoms post-concussion

Patient Description

A 52-year-old female has been experiencing progressive numbness and tingling in her hands, face, neck, chest, and torso since a concussion in March. The sensation is described as electrical shocks or being stung by a bee, worsening with hot water, and lasting from hours to days. She also experiences severe lightheadedness leading to passing out if not seated quickly, along with headaches starting at the back of the head and moving to the front, rated 7/10 in intensity. These headaches are brief but can cause dizziness and tunnel vision. The patient has a history of migraines as a child, but these current headaches feel different. Recently, she was very sick for a week, losing 10 pounds and unable to keep water down. Medical history includes psoriasis and esophagus surgery in 2020. Current medications are Lexapro, Gabapentin, Tramadol (for 20 years due to severe psoriatic arthritis and hip tendon repairs), and Xanax, with an allergy to Prednisone.

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Arora's Assessment

What might be happening

Your symptoms could be related to several issues:

  1. Post-Concussion Syndrome: After a concussion, it's common to experience symptoms like headaches, dizziness, and cognitive difficulties. The tingling and numbness might also be related, although they are less typical.

  2. Cervical Spine Issues: Your bulging discs and spinal stenosis in the neck could be causing nerve compression, leading to tingling and numbness in your hands and face.

  3. Psoriatic Arthritis: This condition can cause joint pain and might contribute to some of your symptoms, although it doesn't typically cause tingling or numbness.

  4. Optic Neuritis: While this primarily affects vision, it can sometimes be associated with neurological conditions that might explain some of your symptoms.

Typical treatments might include physical therapy, medications to manage pain and inflammation, and possibly further neurological evaluation.

What you can do

For Tingling and Numbness:

  • Follow up with a neurologist or spine specialist to evaluate your cervical spine issues.
  • Consider physical therapy to help manage symptoms related to nerve compression.

For Headaches and Dizziness:

  • Keep a headache diary to track triggers and patterns.
  • Ensure you stay hydrated and rest when needed.

For Overall Health:

  • Continue managing your psoriatic arthritis with your current medications.
  • Use MDandMe to journal your symptoms and track progress, which can be helpful for your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Worsening symptoms or new neurological signs, such as weakness or severe headaches.
  • Any changes in vision or persistent dizziness.
  • Difficulty breathing or chest pain.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What is post-concussion syndrome and how long can it last?

Post-concussion syndrome is a complex disorder where various symptoms, such as headaches and dizziness, persist for weeks or months after the initial concussion. It can last for a few weeks to several months, and in some cases, symptoms may persist for a year or more.


Can cervical spine issues cause symptoms like numbness and tingling?

Yes, cervical spine issues, such as bulging discs or spinal stenosis, can compress nerves and lead to symptoms like numbness and tingling in the hands, arms, and sometimes the face.


How can psoriatic arthritis affect overall health and what are common treatments?

Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. It can cause joint pain, stiffness, and swelling, affecting overall health. Common treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics to reduce inflammation and prevent joint damage.


What are the potential causes of headaches that start at the back of the head and move to the front?

Headaches that start at the back of the head and move to the front can be caused by tension headaches, migraines, or issues related to the cervical spine. It's important to track headache patterns and consult a healthcare provider for an accurate diagnosis.


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