OpenHealth Q&A

Could These Symptoms Indicate Seizures?

At 34 years old, weighing 52 kg and standing at 154 cm, I have been diagnosed with conditions such as Ankylosing Spondylitis, thalassemia minor, and vestibular migraines. I have been using flunarizine to manage my migraines for the past week. Recently, I've been diagnosed with vestibular migraines, which seems reasonable in light of certain symptoms I've experienced recently; I’ll provide a detailed outline of these symptoms in a comment, specifically for those interested. As I delved deeper into the subject of vestibular migraines, I stumbled onto information suggesting that some past experiences—which I previously dismissed as irrelevant—may actually bear a resemblance to focal temporal lobe seizures. Additionally, I have other neurological signs that the neurologist overlooked, focusing exclusively on the migraines. I find myself in need of clarity regarding whether some of these episodes could potentially be seizures, and I am uncertain about what steps to take for an evaluation for epilepsy if necessary. This inquiry is particularly important because I have Ankylosing Spondylitis and am about to begin biologic treatments, which I understand may pose complications for individuals with epilepsy. It’s pertinent to note that I have no significant clinical history related to mental health and do not struggle with anxiety or depression, as confirmed through evaluations (I am a psychologist, and this assessment has been a part of my professional training). There is no psychotic history in my family background either. It is also essential to mention that my diagnosis of vestibular migraines included a standard contrast MRI of the brain, which yielded no abnormal findings. My primary health concerns include Ankylosing Spondylitis and Postural Orthostatic Tachycardia Syndrome (POTS), along with thalassemia minor. Here are some potential seizure-like experiences I’ve had: - **Hallucinatory Episodes:** These occur unpredictably while I engage in everyday activities like conversing or crossing the street. Suddenly, I feel immobile and become a passive witness to bizarre, nightmarish visions I initially perceive as real. During these episodes, there’s no panic; they feel surreal yet normal, with a sense of detachment. After a brief moment—perhaps 5 to 10 seconds—I become aware that the experience was unusual, akin to recalling a dream. Despite the peculiar nature of these episodes, I never actually lose consciousness. When they happen during interaction, onlookers often notice that I seem temporarily zoned out. My first encounter with this phenomenon occurred at 15 or 16; a psychologist I consulted dismissed my concerns, suggesting I was merely seeking attention and assured me that psychosis didn’t manifest this way, leading me to disregard it as a quirk of my mind. - **Episodes of Euphoria:** I occasionally feel an unexpected wave of excitement accompanied by intense déjà vu, mixed with derealization and a sensation of "electric air." These episodes also last only a few seconds—between 5 to 20. - **Unexplained Loss of Consciousness:** I once awoke on the floor without any recollection of how I got there. I usually don’t experience syncope due to POTS, which typically features gradual presyncope episodes where I can prepare myself. However, on the occasion I fainted, it was abrupt while I was lightly exercising. I realized I had collapsed, having crashed into objects during my fall. I also experience several neurological symptoms that may or may not be connected to the seizures: - **Myoclonus-like Episodes:** These clusters happen sporadically; for some time—days, weeks, or months—I encounter involuntary twitches prompted by a growing sensation in my spine that culminates in a pronounced twitching event lasting 1-2 seconds. They sometimes amuse my friends, who find them unsettling. The experience bears resemblance to the jerks people have as they drift off to sleep but is a more exaggerated version. - **Bilateral Leg Weakness:** Upon standing, I may feel a growing sensation in my spine, accompanied by extreme muscle fatigue and pressure, which quickly overwhelms me and leaves my legs unsteady, forcing me to sit down to alleviate the feeling of weakness. There have been instances where this culminated in complete saddle numbness, causing significant discomfort, although fortunately, I managed to avoid any serious issues. - **Numbness and Tingling:** I frequently experience sensations of numbness and tingling in various parts of my body, notably around the bridge of my nose and the top of my head, with regional numbness involving my pinky and adjacent toe on the left foot, sometimes accompanied by a burning sensation. I also experience episodes of saddle numbness while seated or standing. - **Difficulty Swallowing:** Occasionally, I encounter a sensation of a lump in my throat, along with food regurgitating unexpectedly. I am aware that my symptoms may not create a clear diagnostic picture, and I suspect that they could stem from different underlying issues rather than a single condition. Any guidance toward a potential direction for further investigation would be immensely valued.

Answers (1)

3/21/2025, 7:01:05 PM

OpenHealth AI

Your concerns about the potential for seizures and their relation to your complex medical history are valid and important to address. The experiences you've described could be linked to several conditions, including neurological processes, and it’s crucial to seek clarity on these symptoms as you prepare for biologic treatments.

Key Points:

1. Your symptoms may resemble seizure activity, but not all experiences necessarily indicate epilepsy.
2. A thorough assessment will help differentiate between seizure activity and other episodes.
3. Monitoring and document symptoms is essential for any healthcare evaluation.

Explanation:

The symptoms you've described, such as hallucinatory episodes, feelings of euphoria, unexplained loss of consciousness, and other neurological signs, can align with both seizure disorders and other conditions such as vestibular migraines, anxiety, or side effects of medications. Your MRI results being normal is reassuring, but further investigation may still be warranted due to the nature of your symptoms and existing conditions like Ankylosing Spondylitis and POTS.

It’s important to differentiate between true seizures (which involve abnormal electrical activity in the brain) and other non-epileptic events. The existence of myoclonus and episodes of weakness could also be neurogenic or related to your other underlying health issues.

Next Steps:

1. Keep a Symptom Diary: Record details of each episode, including the duration, description of what happens, any triggers, and how you felt afterwards. Include notes on when the episodes started and any patterns you notice. This will provide valuable information for any healthcare professional you consult.

2. Consider a Neurology Consultation: Look for a neurologist who specializes in epilepsy or seizure disorders. Present your symptom diary and discuss your past episodes and how they relate to your current health issues.

3. Discuss Your Concerns About Treatment: When approaching biologic treatment for Ankylosing Spondylitis, ensure you have a complete picture of your neurological status. Discuss your symptoms and their implications for treatment with your healthcare team.

4. Avoid Self-Diagnosing: While researching symptoms can be helpful, they should not replace professional evaluation. Trust the expertise of specialists who can assess your condition holistically.

5. Review Current Medications: Since you’re taking flunarizine for migraines, discuss this with your provider to understand if it may be connected to your symptoms or if adjustments are needed.

By taking these steps, you can better understand your symptoms and ensure that you receive the most appropriate care for both your migraines and any potential seizure activity. If you experience severe symptoms, such as significant loss of consciousness or novel neurological deficits, it’s imperative to seek immediate medical attention.