<s>[INST] Trying to find what could be wrong with my eight year old son. These are his symptoms: 6+month symptoms Recurring nose infection/bleeds goes away only with topical antibiotics Acid reflux (was on prescription 6mo prior now infrequent 2-3x mo treated tums) 3+ month symptoms Headache- usually @evenings 3-4x wk Audio hallucinations 1x wk (not threatening) Visual hallucinations 1-2x day 4-7x wk (shadow people only) Light headed spells last under 1 min 2-4x day (Usually when sitting down. Not occurring in a transaction from sitting to standing etc) he says spinning and he looks pale History: South Carolina east coast No travel out of country He is fit muscle/tone not overweight but bad diet with take-out and sweets Hit head 2 bad occasion- diagnosed concussion age 3 (bunkbed) / nothing found age 8 (trampoline) hallucinations seem to begin after this incident? Hand and foot disease Nov 2017-antibiotics Feb 2018 Lost all lunula s (half moons were just holes in nailbeds) @ all 20 fingernails and toenails half moons were all holes where lunula should be. had blood work done to rule out iron deficiency. Test results iron good Just had MRI was clear (rule out tumor @ hallucinations/injury from trampoline) Doctor sends him to psychologist. psychologist thinks I should continue to seek medical advice to rule out other medical conditions. Sorry to muddy the waters but want to show all history in case one has to do something with the other. [/INST] Hi, If MRI brain turned out to be normal then medical cause is unlikely, a metabolic profile can be done for degenerative brain disease and Wilson disease, but it still has findings on MRI. Psychiatric consultation is also a good option because it will help in both ways. Recurrent nose infection and bleed are recent symptoms that should be investigated with full blood count and coagulation profile. Hope I have answered your query. Let me know if I can assist you further.  </s>