HomeAnswersNeurologyauditory hallucinationsWhat could be the cause for my various neurological problems?

I have many problems like hallucination, forgetfulness, soreness of hands, etc. Kindly help.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At September 24, 2020
Reviewed AtSeptember 24, 2020

Patient's Query

Hello doctor,

I am a 29-year-old female. I am an occasional drinker and social smoker (pack a week). Until the last 4 years, I jumped from career to career due to the inability to perform duties. No prior surgeries or diagnoses other than EDS (idiopathic hypersomnia) at the age of 23. I take multi gummy (zinc, calcium, and magnesium) supplement and 15 mg Adderall a day.

I had at home sleep study, four inpatient sleep studies, including two daytime latency tests. Both inpatient studies showed restless sleep with prolonged REM dream stages. I took less than six minutes to fall asleep each time on average and woke without memory approximately 40 times in six hours. Sleepwalking consistently happens until the age of 15. All bloodwork are normal. No history of high blood pressure.

I took one MRI with and without contrast three years ago, and x-rays of neck and spine recently without abnormal findings. Physical therapist refused to treat due to fear of disability. I underwent behavioral therapy and psychiatrist determined unnecessary. History of cancer and tumors of all types on both paternal and maternal sides. I consult GP and pulmonary/sleep lab regularly.

My symptoms are as follows:

Frequent urination with incontinence, nausea with vomiting occasionally most often in the morning or before bed, vertigo/dizziness double vision with flashes and spots, tingling and numbness of hands, arms, and feet sometimes calves. Long lasting migraines behind the right eye, neck spasms/constant pain with stiff neck that is sudden and sometimes long lasting. I had those since young age but progressively gotten more painful and recurring. It starts hot at the base of the neck and travels to the forehead and tongue. I have a lack of focus and concentration with brain fog. I have slurred speech, unable to type or write or read frequently. Previously, I had fantastic photographic memory, but now I have severe forgetfulness, loss of balance in walking or jumping, and tripping. Inability to move and walk dead limbs, pigeon-toed, frequent night terrors, loss of appetite, unexplained weight loss and gain. I have rapid mood changes without cause (irritability), hallucinations, and hearing things that are not there.

Soreness and stiff hands, fingers, and wrists, scratching sound in the right ear with pressure, chest pain without high blood pressure, pressure behind right eye sensitivity to light.

Spider crawling sensations on the scalp and base of the neck at night, mood swings, and severe sadness outbursts of tears for no reason. Detachment from reality and feeling unaware of what is going on (confusion), mouth and face, lip, eyebrow twitching mostly on the right side. Discomfort in feet and legs while sitting or lying down, unable to sit with feet crossed for more than a minute. Weird ammonia chemical-like taste and smell, cannot taste eating or drinking. I am currently on Provigil and Ritalin.

Answered by Dr. Aida Abaz Quka

Hello,

Welcome to icliniq.com.

I read carefully your question and would explain that your situation seems to be really complex.

Coming to this point, I would recommend checking some blood lab tests:

1. Vitamin B12 and D plasma levels for possible deficiency.

2. Thyroid hormone levels for possible thyroid gland dysfunction.

3. Urine analysis and urinary tract ultrasound would be needed too.

4. Brain MRI would help exclude any possible brain disorder, considering your clinical situation.

If all the above tests results are normal, I would recommend starting treatment with Olanzapine coupled with Topiramate. Other treatment options would be Venlafaxine or Sertraline. All these drugs are given under medical prescription. You should discuss with your doctor on the above treatment options.

Patient's Query

Thank you doctor,

I have had recent blood work and urine tests and thyroid hormones tested all came back normal. I never had an UTI or stones or anything of the sort. I am scheduled for another MRI including brain stem this time as the first one also showed no abnormalities. I hope that I am able to get some answers from that. If you have any other ideas I would love to hear them. All specialists I have seen are puzzled an no one knows why I am experiencing such awful symptoms.

Answered by Dr. Aida Abaz Quka

Hello,

Welcome back to icliniq.com.

Based on these tests, no sleep apnea, but idiopathic hypersomnia.

Normal brain MRI.

Normal cervical spine MRI, besides a small disc.

I would recommend performing the above-mentioned blood lab tests.

Regarding the hallucinations, Olanzapine can help improve your situation. Regarding the headaches, they could be migraine or tension-type headache. I think that Topiramate can help in this regard. If your situation does not improve with these two drugs, then the next step to follow would be adding Fluvoxamine or Sertraline to your therapy.

Regarding your sleep disorder, I agree with the medications that you have been trying. You should discuss with your doctor the above treatment options and blood lab tests.

I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Aida Abaz Quka
Dr. Aida Abaz Quka

Neurology

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