[71F] Experiencing severe dizziness, double vision, and widespread pain

Patient Description

A 71-year-old female presents with severe dizziness, double vision, nausea, and widespread pain. The dizziness is worse with movement and can lead to nausea, which is moderate to severe and exacerbated by any kind of movement. The double vision, present for over a year, causes the patient to see two of everything and is somewhat alleviated by focusing on a single point. The patient also experiences significant bone and joint pain, described as burning and numbing, which has worsened over the past six months. Muscle weakness has become severe, particularly affecting the patient's grip and leg strength, impacting daily activities and mobility. The patient has a complex medical history including a total left knee replacement, a fused and shorter left leg, breast cancer treated 21 years ago, a perforated bowel with an abscess, kidney stones, and a past pulmonary embolism. Current medications include a blood thinner, asthma medication, proton pump inhibitors, antidepressants, a medication to stop tremors, and thrice-weekly antibiotics to maintain lung health. Notable medication allergies include Neurontin, which causes suicidal thoughts, and pain medications that cause stomach upset.

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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 chronic disease that affects the central nervous system, particularly the brain and spinal cord. It can cause a wide range of symptoms, including fatigue, dizziness, double vision, pain, and muscle weakness. It's typically diagnosed with an MRI scan.

    • Treatment usually involves managing symptoms and slowing the progression of the disease with medication.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It's often considered when there's no clear cause for the pain.

    • Treatment typically involves a combination of medication, exercise, stress management techniques, and healthy lifestyle habits.
  • Vestibular disorders: These are conditions that affect the inner ear and balance system, which could explain your dizziness and nausea. Common examples include benign paroxysmal positional vertigo (BPPV), Meniere's disease, and vestibular neuritis.

    • Treatment depends on the specific disorder, but may include physical therapy, medication, and in some cases, surgery.

Please note that these are just possibilities based on the symptoms you've described. It's important to consult a healthcare provider for an accurate diagnosis.

What you can do

  1. Consult a healthcare provider: Given the severity and duration of your symptoms, it's crucial to seek medical attention. They can conduct a thorough evaluation, order necessary tests, and provide appropriate treatment.

  2. Keep a symptom diary: This can help you track your symptoms and identify any patterns or triggers. Be sure to note the severity, duration, and any activities that seem to make your symptoms worse.

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

  4. Rest and take care of your mental health: Chronic symptoms can be stressful and exhausting. Make sure to take time for rest and relaxation, and consider talking to a mental health professional if you're feeling overwhelmed.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Sudden, severe headache
  • Difficulty breathing
  • Chest pain
  • Sudden weakness or numbness on one side of your body
  • Loss of consciousness

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


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

Common symptoms of Multiple Sclerosis (MS) include fatigue, dizziness, double vision, pain, muscle weakness, and problems with coordination and balance. Diagnosis typically involves an MRI scan and other tests to assess neurological function.


How is fibromyalgia diagnosed and treated?

Fibromyalgia is diagnosed based on a history of widespread pain lasting more than three months, along with other symptoms like fatigue and sleep disturbances. Treatment often includes medication, exercise, stress management, and lifestyle changes to manage symptoms.


What are vestibular disorders and how do they affect balance?

Vestibular disorders affect the inner ear and balance system, leading to symptoms like dizziness, vertigo, and nausea. Conditions such as benign paroxysmal positional vertigo (BPPV), Meniere's disease, and vestibular neuritis are examples. Treatment varies but may include physical therapy, medication, or surgery.


What should I do if I experience sudden severe symptoms like a headache or chest pain?

If you experience sudden severe symptoms like a headache, chest pain, difficulty breathing, or sudden weakness or numbness on one side of your body, seek immediate medical attention as these could be signs of a serious condition.


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