Please share ur expertise

[Madhatter]

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hi! could someone be so kind as to help me out with a difficult case. a 53 yo woman has a lack of interest in things, lack of patience, strong anger fits, bitterness, complains of freezing feeling traveling up from the base of her neck upwards in her brain, and also forgets roads that she travels on frequently. what could this be?? 😕

 

[50960]

Sounds like you need to start by ruling out some form of dementia and/or major depression as well as all the medical r/o's.

🙂

 

[Madhatter]

i found out that she does have hypothyroid, but is on medication for that. but what effect could hypothyroid have on the symptoms i listed in the original post??

 

[john182]

hi! could someone be so kind as to help me out with a difficult case. a 53 yo woman has a lack of interest in things, lack of patience, strong anger fits, bitterness, complains of freezing feeling traveling up from the base of her neck upwards in her brain, and also forgets roads that she travels on frequently. what could this be?? 😕

DO a Geriatric Depression Scale and MMSE as screening as well. If she says it's a freezing sensation going from her neck base to top of head is mighty different if it's specifically going to her BRAIN!

 

[watto]

I would do an MMPI to check for Axis II d/o, possibly borderline w/ the increased irritability and anger...some have tactile hallucinations as well.

 

[Miklos]

hi! could someone be so kind as to help me out with a difficult case. a 53 yo woman has a lack of interest in things, lack of patience, strong anger fits, bitterness, complains of freezing feeling traveling up from the base of her neck upwards in her brain, and also forgets roads that she travels on frequently. what could this be?? 😕

No expertise here, just a wild thought.

What about MS? This 'freezing' vaguely sounds like Lhermitte's sign. Additionally, vague symptoms corresponding to a diagnosis of psychoneurosis are often associated with a primary presentation of MS.

 

[psydoc]

Hi Madhatter!
Could it be that her treatment for hypothyroidism is not working as it should for some reason (i.e. poor compliance to treatment)? Freezing, forgetfullness and intellectual impairment, depressed mood could all be related to that condition. You might consider ordering TSH, fT3, fT4 or talking to her primary care physician or endocrinologist.
I also think that you might get some clues from a thorough history (previous depressive episodes, traits suggestive of personality pathology, as watto pointed out).
She seems to be a little too old for an MS onset and a little too young for a dementia, but you will probably have to consider those as well.
Good luck!