Brief Answer:
Cnsultation

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. These symptoms could be either psychological or neurological

: Chronic fatigue syndrome - It is a condition which is caused by extreme work stress. It presents as mental stress, fatigue, muscle spasms, weakness, loss of interest, loss of appetite and all those symptoms which you have mentioned.
It can be suspected if everything else comes normal like Vitamin B12 level, X ray cervical spine, MRI cervical spine/head.

It can be treated by
; bed rest
; take a vacation
; you can give her painkiller like Tab Diclofenac after proper prescription
; apply painkiller gel like Diclofenac gel after proper prescription.
; Give her multivitamin capsules to treat any deficiency like Vitamin B complex, vitamin C.
; Ask her to start Yoga or Meditation or Exercise
; If still in no relief, consult doctor.

: Depression - It can present with similar symptoms. It can be suspected if loss of sleep, early morning awakening, loss of interest, no organic cause, history of some major bad life event.

It can be treated by
; Consult Psychiatrist
; Family support
; Tablet Tricyclic Antidepressants like Amitriptyline/Nortriptyline/Doxepin after proper prescription. Therapy is usually given for 6-8 weeks in which it treats depression.
; Tablet SSRIs like Fluoxetine/Duloxetine/Sertaline etc after proper prescription.
; There are so many other antidepressants. The doctor will prescribe according to your daughter symptoms and response.
; Psychotherapy
; Behavioural therapy

: Organic cause could be
Cervical spondylosis
Deficiency disease like Vitamin B12, Vitamin D3

It can be ruled out by consulting doctor and getting evaluation/blood and radiological investigations like
: MRI cervical spine
: Serum Vitamin B12 level
: Serum Vitamin D level

After confirming diagnosis, it can be treated by
: B12 deficiency like injection vitamin B12 1500microgram daily till level normalise. It is given after proper prescription.
: Vitamin D deficiency by giving vitamin D 60,000 IU tablets once a week for 3 months in an adult after proper prescription
: Cervical spondylosis can be treated only after confirming diagnosis and degree of prolapse. It can be either conservative or surgical.


Hope it will help her. If still in doubt, do let me know.

Thanks. Take care.

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