Which Specialist Should I See for My Neurological Symptoms?

Could you please tell me which symptoms you are experiencing so I can recommend the appropriate specialty and tests for a detailed examination?

Three months ago, while at work, I felt a tightness in my chest, so I stretched my arms out.
However, the condition did not improve, and then my vision completely went white, I couldn't see anything, I experienced difficulty breathing, felt like the air was thin, and I broke out in a cold sweat.
I then went to the emergency department for an examination, and by that time, my condition had improved significantly.
The emergency staff performed an electrocardiogram (ECG), X-rays, and blood tests, all of which came back normal.
The doctor diagnosed it as a sudden spasm.

In the past week or two, due to work, I have been using my right hand extensively, which may have caused muscle tightness and discomfort in my right back.
The day before yesterday, when I woke up, I felt a tightness in my back again, so I stretched a bit, and the symptoms of white vision and cold sweats returned.
Once my vision returned to normal, my neck and right arm were almost immobile and painful with any movement.

I would like to ask which specialty I should consult and what kind of examinations I should undergo to find the cause of this issue.
Thank you for your assistance!

Debby, 20~29 year old female. Ask Date: 2022/12/14

Dr. Peng Shiwei reply Neurology

Hello, based on your symptoms, it may be advisable to first consult a cardiologist for a basic evaluation related to syncope.

Reply Date: 2022/12/14

More Info

When experiencing neurological symptoms such as chest tightness, visual disturbances, difficulty breathing, and muscle pain, it is crucial to seek the appropriate medical specialist to ensure a thorough evaluation and accurate diagnosis. Based on the symptoms you've described, it would be advisable to start with a visit to a primary care physician or a family medicine doctor. They can conduct an initial assessment and determine if a referral to a specialist is necessary.

Given your symptoms, particularly the episodes of visual disturbances and muscle tightness, a neurologist would be a suitable specialist to consult. Neurologists specialize in diagnosing and treating conditions related to the nervous system, which includes the brain, spinal cord, and peripheral nerves. They can perform a comprehensive evaluation, including a neurological examination, to assess your symptoms further.

In addition to a neurologist, considering your symptoms of chest tightness and breathing difficulties, it may also be prudent to consult a cardiologist. Although your initial tests, including an electrocardiogram (ECG) and chest X-ray, returned normal, a cardiologist can provide further insights into any potential heart-related issues that may not have been evident during your emergency visit.

For your muscle tightness and pain, particularly in your right back and arm, a visit to a physical therapist or an orthopedic specialist may also be beneficial. They can evaluate your posture, muscle strength, and any potential musculoskeletal issues that could be contributing to your discomfort.

In summary, the following steps are recommended:
1. Primary Care Physician: Start with a visit to your primary care doctor for an initial assessment. They can help coordinate your care and refer you to specialists as needed.

2. Neurologist: If neurological symptoms persist, a neurologist can conduct a detailed evaluation, including potential imaging studies like an MRI or CT scan to rule out any underlying neurological conditions.

3. Cardiologist: Given your history of chest tightness and breathing difficulties, a cardiologist can evaluate your heart health further, especially if symptoms recur.

4. Physical Therapist/Orthopedic Specialist: For muscle tightness and pain, a physical therapist can provide exercises and treatments to alleviate discomfort and improve mobility.

It is essential to communicate all your symptoms clearly to each specialist, including the timing, duration, and any triggers associated with your episodes. Keeping a symptom diary can be helpful to track patterns and provide detailed information during your consultations.

In conclusion, addressing your neurological symptoms requires a multidisciplinary approach. By starting with your primary care physician and potentially involving specialists in neurology, cardiology, and orthopedics, you can work towards identifying the underlying causes of your symptoms and receiving appropriate treatment. Remember to advocate for your health and seek immediate care if your symptoms worsen or if you experience new concerning symptoms.

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