Neurological Symptoms: Dizziness, Fatigue, and Unusual Sensations

Dizziness, fatigue, electric shock sensations, and occasional numbness?

Hello Doctor, I have always been healthy, exercising daily (running 10 kilometers per hour) and going to the gym four times a week for strength training.
I have maintained an athlete's physique since my youth.
However, since the beginning of this year, I have experienced several symptoms, which I will explain.

1.
I often feel as if someone is gently touching my head or that there is a breeze lifting my hair, even though there is none.

2.
I frequently feel a slight vibration in my genital area, similar to the sensation of a phone vibrating in my pocket.

I didn't think much of these symptoms until May 2nd of this year, when my aura migraine flared up.
After that, my overall condition changed completely, as described below:
1.
My eating, drinking, and sleeping habits are normal, but I feel dizzy every day, with a heavy sensation in my head.
I still feel dizzy upon waking up in the morning, but my physical strength is fine, and I can still run 10 kilometers.

2.
In the afternoon, I feel completely off; I am extremely fatigued and unable to do anything.
Sometimes I find myself pausing while speaking, and I often struggle to articulate certain words, which is very uncomfortable.

3.
By evening, everything returns to normal; even if I go to bed at 2 AM, I feel energetic.

4.
Occasionally, I still experience a tingling sensation in my genital area, especially after masturbation, but without ejaculation.

5.
After exercising, my left hand sometimes feels numb, while my right hand does not.

6.
Sometimes my body itches, and when I scratch, it feels like there is a barrier preventing me from reaching the itch.

7.
There is a slight pain in my genital area, but urination is normal and painless, and I do not experience incontinence.

I do not smoke, drink alcohol, or consume coffee, and I eat a light diet.
However, my entire body has changed since May 2nd.
I have searched extensively online and believe the closest conditions are neuropathy or diabetes, but there is no family history of diabetes, and my physique is normal (185 cm, 80 kg, 18% body fat) without symptoms of the three highs.
I do have a hereditary predisposition to aura migraines, which occur about once a year.

I hope the doctor can provide me with some advice on seeking medical attention.
Thank you.

Danxin de ren, 40~49 year old female. Ask Date: 2009/06/01

Dr. Chen Haorong reply Neurology

Based on the content of your inquiry, it is indeed possible that you are experiencing neuritis, and in some cases, the condition may be more severe than neuritis.
It is recommended that you promptly visit a large hospital for further evaluation, which may include blood tests, neurophysiological examinations, imaging studies, and, if necessary, a lumbar puncture for cerebrospinal fluid analysis, in order to confirm the underlying cause.
Thank you.

Reply Date: 2009/06/01

More Info

Based on your detailed description of symptoms, it seems you are experiencing a complex interplay of neurological and possibly psychological issues. Your symptoms, including the sensation of being touched on the head, vibrations in the genital area, persistent dizziness, fatigue, and unusual sensations, can be quite distressing. Let's break down these symptoms and explore potential causes and recommendations for further evaluation.

1. Sensory Disturbances: The sensations you describe, such as feeling a light touch on your head or vibrations in your genital area, can be indicative of sensory nerve involvement. These types of sensations can sometimes be associated with neurological conditions, including peripheral neuropathy or even anxiety-related disorders. Given your history of migraine with aura, it’s possible that these sensations could be related to migraine-related neurological phenomena. Migraines can sometimes cause transient sensory disturbances due to changes in blood flow or nerve activity in the brain.

2. Dizziness and Fatigue: The persistent dizziness and fatigue you experience, especially the contrast between your morning and evening energy levels, could suggest several underlying issues. One possibility is that you might be experiencing a form of postural orthostatic tachycardia syndrome (POTS), which can cause dizziness and fatigue upon standing or during the day, but may improve when you are at rest. Another consideration is that your symptoms could be related to anxiety or stress, which can manifest physically and lead to fatigue and cognitive difficulties, such as trouble finding words or speaking.

3. Neurological Evaluation: Given the complexity of your symptoms, it would be prudent to undergo a thorough neurological evaluation. This may include imaging studies such as an MRI or CT scan to rule out any structural abnormalities in the brain. Additionally, nerve conduction studies and electromyography (EMG) could help assess for any peripheral nerve issues.
4. Blood Tests: While you mentioned that you do not have a family history of diabetes, it may still be beneficial to have blood tests done to check for glucose levels, thyroid function, vitamin deficiencies (such as B12), and other metabolic conditions that could contribute to your symptoms.

5. Psychological Factors: It’s important to consider the role of psychological factors in your symptoms. Anxiety and stress can lead to physical manifestations, including dizziness, fatigue, and sensory disturbances. Cognitive-behavioral therapy (CBT) or other forms of counseling may be beneficial in managing anxiety and its physical symptoms.

6. Lifestyle Considerations: While you maintain a healthy lifestyle with regular exercise, it’s essential to ensure that you are also managing stress effectively. Techniques such as mindfulness, yoga, or meditation can help reduce anxiety and improve overall well-being.

7. Follow-Up: I recommend scheduling an appointment with a neurologist to discuss your symptoms in detail. They may suggest a comprehensive workup to rule out any neurological conditions and provide you with a tailored treatment plan based on their findings.

In summary, your symptoms warrant a thorough investigation to rule out any underlying neurological or metabolic conditions. Additionally, addressing any psychological factors may also be crucial in managing your overall health. Please ensure to communicate all your symptoms clearly to your healthcare provider, as this will aid in accurate diagnosis and treatment.

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