[59F] Experiencing weakness, dizziness, and memory issues post-spinal tumor removal

Patient Description

A 59-year-old female presents with a complex medical history, including a benign spinal cord tumor removed 3 years ago, IBS, PCOS, and adult growth hormone deficiency. She reports a 3-year history of worsening weakness, particularly after starting activities, and generalized weakness that affects the left side more frequently. Dizziness described as a sensation akin to being on an amusement park ride occurs almost daily and has been present for about 4 years. She experiences back spasms and sensations similar to electric shocks, with severe pain ranging from 7-10, which began after a head-on collision in September 2020. Tingling in the hands, resembling the feeling of a tens unit, has been present for 6 months. Memory loss has been an issue for about a year, with difficulty retaining recent information. Imbalance causing stumbling started approximately 4.5-5 years ago and has increased in frequency over the past year. The patient also experiences constant exhaustion, severe eye pain with certain eye movements, and a persistently dry mouth. She is currently taking Hydrocodone for back pain and Amitriptyline for migraines, along with various vitamins and supplements. She has a history of severe reactions to Codeine, Sulfa drugs, and Zithromax, and an allergy to honey bees.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several conditions could be considered:

  • Multiple Sclerosis (MS): This is a disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms can include fatigue, difficulty walking, numbness or tingling, muscle weakness, pain, and problems with coordination and balance. MS could also explain the cognitive difficulties you've been experiencing. However, this is a serious diagnosis and would need to be confirmed by a neurologist through specific tests.

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. It's often triggered by a physical trauma, like a car accident. The constant fatigue and cognitive difficulties you've described are sometimes referred to as "fibro fog."

  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. Other symptoms can include loss of memory or concentration, unexplained muscle or joint pain, and extreme exhaustion lasting more than 24 hours after physical or mental exercise.

  • Vitamin B12 Deficiency: This can cause a variety of neurological symptoms, including numbness and tingling in the hands and feet, balance problems, and cognitive difficulties. Given that you're taking B12 supplements, this is less likely but still possible, depending on your dosage and how well your body is absorbing the vitamin.

  • Side Effects of Medication: Both Hydrocodone and Amitriptyline can cause various side effects, including dizziness, fatigue, and cognitive difficulties. It's possible that these medications could be contributing to your symptoms.

Please remember that this is not a definitive diagnosis. It's important to discuss these possibilities and your symptoms with a healthcare provider, who can provide a formal diagnosis and appropriate treatment options.

What you can do

  1. Schedule an appointment with your healthcare provider: Given the number of symptoms you're experiencing and their impact on your daily life, it's important to seek medical attention. If you haven't already, consider seeing a neurologist, who specializes in the types of symptoms you're experiencing.

  2. Keep a symptom diary: This can help you track when your symptoms occur, their severity, and any potential triggers. This information can be helpful for your healthcare provider in diagnosing your condition.

  3. Stay hydrated and maintain a balanced diet: This can help manage your symptoms and overall health.

  4. Regular exercise: If possible, try to incorporate regular physical activity into your routine. This can help manage symptoms such as fatigue and cognitive difficulties. However, it's important to not push yourself too hard and to rest when needed.

  5. Rest: Make sure you're getting enough sleep each night. If you're having trouble sleeping, speak with your healthcare provider about potential solutions.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden worsening of any of your symptoms
  • New symptoms, such as severe headaches, changes in vision, difficulty speaking, or difficulty swallowing
  • Symptoms that interfere with your ability to eat or drink
  • Symptoms that interfere with your ability to perform basic tasks, such as dressing yourself or walking

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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9 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, pain, and problems with coordination and balance. Cognitive difficulties can also occur.


How can a car accident trigger fibromyalgia?

A car accident can trigger fibromyalgia by causing physical trauma, which may lead to widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive issues, often referred to as 'fibro fog.'


What are the potential side effects of taking Hydrocodone and Amitriptyline together?

Taking Hydrocodone and Amitriptyline together can lead to side effects such as dizziness, fatigue, cognitive difficulties, and increased risk of sedation. It's important to monitor these effects and discuss them with a healthcare provider.


How can vitamin B12 deficiency affect neurological health?

Vitamin B12 deficiency can lead to neurological symptoms such as numbness and tingling in the hands and feet, balance problems, and cognitive difficulties. It is important to ensure adequate intake and absorption of vitamin B12 to maintain neurological health.


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