Brief Answer:
Please discuss the possibilities with her to reach the most likely cause

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us.

I would like to go directly into the details, but as I am not physically present to help her by gaining more clarity in her condition, I would like to provide you with a list of most likely causes and would like you to take it up with her and accordingly advise her the required information:

1. If she ate just a while before her presentation then it could be due to either an allergy or some kind of poisoning (e.g. seafood poisoning)

2. If she has not eaten for quite some time, then it could be due to hypoglycemia (drop in blood sugar level) either due to medications, lifestyle or long gap between last meal

3. Infections (e.g. herpes): will require ruling out if all other conditions are ruled out

4. Raynaud's phenomenon: triggered by cold temperature or stress; but also seen are blushing peripheries (hands and/or feet)

5. Neurological conditions: Like multiple sclerosis, etc. Will require a neurological consultation at her earliest convenience

6. Panic attack: Ask her if she was stressed or tensed about something, if so then this is quite possible. She just needs to relax and she should start feeling better

7. Menopause: If she has been experiencing menstrual irregularities off-late then this is the most likely cause. a Absolutely nothing to worry about, just ask her to try to relax and schedule an appointment with her doctor at her earliest convenience

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