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I have had hot flashes, severe fatigue, headaches for days, terrible fatigue, leg pain, shoulder pain, neck pain, blurry vision, and cognitive issues for six months. Neurologist said it was coincidence. Where do I go next? Blood work was normal as was a brain MRI. Answer: We are very sorry to hear that you have suffered for so long without answers. While it is not possible to establish a direct doctor-patient relationship on our website, we can help you analyze your problem so that you are at least asking the correct questions. The most important observation I can make is that your symptoms do not necessarily indicate any neurological problem. For instance, fatigue and body pain are two of the most common symptoms in medicine, both caused by a multitude of ailments. Your only two suggestive neurologic symptoms are blurry vision and "cognitive issues". Blurry vision is easy for an ophthalmologist to evaluate. One of the most common causes for blurry vision these days is dry eyes often exacerbated by staring at computer or cell phone screens for a prolonged period. I am not sure what you mean by, "cognitive issues", but the perception of fogginess, forgetfulness, inability to concentrate and word finding delays ("tip of the tongue phenomenon") are often related to disrupted sleep, stress, anxiety or depression. You need to find a good family doctor or internist who will work with you to address your constellation of symptoms in a methodical and organized manner. You must approach your problem with an open mind to possibilities you may not have considered and accept that lifestyle adjustments may be required on your part to help alleviate your symptoms. Good luck to you. Revere (Rip) Kinkel MD Director of the Multiple Sclerosis Program Professor of Clinical Neurosciences University of California San Diego
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