Symptoms: When to See a Neurologist for Your Health Issues

Autonomic nervous system dysfunction? Cold? Other brain issues?

On the evening of October 22nd, I felt muscle weakness, my whole body was hot, and I sweated excessively while sleeping due to overheating.
I woke up after two hours to rehydrate, but by the time I went to work, I had a headache, a sensation of heat and swelling throughout my body, no appetite, dry mouth, a cough, and symptoms similar to a cold, along with muscle pain and numbness.
From the night of October 23rd to October 24th, I drank clam extract and ate normally, going to bed early.
The fever symptoms disappeared on the 24th, but my headache worsened.
When I cough, I feel intense pain in the area at the back of my nasal cavity and the center of my brain.
Coughing is painful, and pressing on the temples is more painful than usual.
I have a habit of staying up late and smoking, and I spend my workdays in front of a computer.
I have a long history of insomnia.
On the first day of symptoms, I went to bed much earlier than usual, but upon waking, the symptoms were more severe.
Should I see a neurologist, an internist, or an otolaryngologist?

ALEX, 20~29 year old female. Ask Date: 2012/10/24

Dr. Gao Chunde reply Neurology

Based on the symptoms, it appears to be a cold.
However, if there is a fever, headache, and neck stiffness, it is advisable to consult a neurologist to rule out the possibility of meningitis.
If those symptoms are not present, it is recommended to rest more and drink plenty of fluids, and see a doctor for medication if necessary.
Regarding long-term insomnia, you can wait until the cold resolves and then visit a neurologist or a psychosomatic medicine clinic for assistance in addressing the issue.

Reply Date: 2012/10/24

More Info

Based on the symptoms you've described, it seems that you are experiencing a combination of physical and neurological issues that warrant a thorough evaluation. Your symptoms include muscle weakness, excessive sweating, headaches, a feeling of heat and swelling, loss of appetite, dry mouth, cough, and pain in the nasal area and temples. These symptoms can be indicative of several underlying conditions, and it is essential to approach this systematically.

Firstly, the combination of muscle weakness, headaches, and the feeling of heat could suggest a few possibilities. For instance, these symptoms might be related to a viral infection, especially given the cough and the feeling of malaise. Viral infections can lead to systemic symptoms such as fever, muscle aches, and headaches. However, the specific pain you feel in the nasal area when coughing could indicate sinus involvement, which might require an evaluation by an ear, nose, and throat (ENT) specialist.

Additionally, your history of insomnia and smoking can contribute to various health issues, including chronic headaches and respiratory problems. Chronic sleep deprivation can lead to increased sensitivity to pain and exacerbate feelings of fatigue and malaise. Smoking can also affect your respiratory health, leading to chronic cough and other complications.

Given the complexity of your symptoms, it is advisable to start with a visit to your primary care physician. They can perform a comprehensive assessment, including a physical examination and possibly some initial tests (like blood tests or imaging studies) to rule out any serious conditions. If your primary care physician suspects a neurological issue, they may refer you to a neurologist for further evaluation. Neurologists specialize in disorders of the nervous system, and they can provide insights into whether your symptoms are related to neurological conditions such as migraines, tension-type headaches, or other disorders.

If your symptoms are primarily related to sinus issues, such as pain in the nasal area and headaches that worsen with coughing, an ENT specialist would be the appropriate choice. They can evaluate for sinusitis or other related conditions that could be causing your symptoms.

In summary, here’s a step-by-step approach you might consider:
1. Visit Your Primary Care Physician: Start with a comprehensive evaluation to assess your symptoms and medical history. They can guide you on whether you need to see a specialist.

2. Consider a Neurologist: If your primary care physician suspects neurological involvement, they may refer you to a neurologist for further evaluation.

3. Consult an ENT Specialist: If your symptoms suggest sinus issues, an ENT specialist can provide targeted treatment.

4. Lifestyle Modifications: Addressing lifestyle factors such as smoking and improving sleep hygiene can significantly impact your overall health and symptom management.

5. Monitor Symptoms: Keep a detailed record of your symptoms, including their onset, duration, and any potential triggers. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

In conclusion, while it may be tempting to self-diagnose or jump to conclusions about your health, a structured approach involving a healthcare professional is crucial. They can help you navigate your symptoms and determine the best course of action for your health.

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