OpenHealth Q&A

What Could Be Causing My Episodes?

I am 31 years old, weigh 195 pounds, and currently take Wellbutrin, Vyvanse, and Plaquenil (which I will be discontinuing soon as indications are I do not have Lupus or any autoimmune disorders). I also experience some level of dysautonomia and was diagnosed with fibromyalgia in 2009. Additionally, I have endometriosis and previously underwent surgery for carpal tunnel syndrome in both wrists. Over the last year, I've been grappling with numerous health issues, and it has been quite perplexing, leaving me without many definitive answers. One particular episode has compelled me to seek clarity. Last summer, I encountered several instances where I nearly fainted after slowly rising from a crouched position. During these moments, I experienced dim or tunnel vision, felt disoriented, struggled to articulate my thoughts, and often found myself unable to reply or continue my sentences, as if my mind had gone blank. These episodes typically lasted only a few seconds, with the longest being about ten. In the fall, I was diagnosed with some form of dysautonomia following a stress test that revealed my blood pressure dropped drastically—approximately 100 points—within a minute of ceasing the test. Reflecting on those early episodes, I realized that the sensations I felt did not mirror how I felt during the stress test aftermath (lightheadedness, tunnel vision, nausea, and cold sweat), nor were they the same as when I came close to fainting during blood draws or previous blood donation experiences. In early February, I had another episode that seemed to extend for about five minutes, prompting me to speak with my doctor about my concerns. During this occurrence, I remained functional to some extent, but it was immensely challenging. I didn't engage in conversation until close to the conclusion of the event. It felt as though I was detached from my body, floating in a fog, and executing any physical action required substantial effort. I completed a simple work task but struggled intensely to communicate with a colleague regarding my plans for a break, managing only a few stuttered words before getting stuck. I could sense the concern in my coworker's expression as I appeared confused, yet I couldn't express my distress or need for assistance. I felt a wave of overwhelming emotion and wanted to cry but found the tears were just out of reach. Eventually, I regained composure and, feeling shaken, went on my lunch break, only to experience a hysterical breakdown over how frightening it all was. I convinced myself I was overreacting and returned to work afterward. Around that time, I also endured an excruciating headache, the worst I have ever experienced, which lasted several days. I am unsure whether that is connected to the other episodes. Recently, a sleep-deprived EEG was conducted after my primary care physician suggested my experiences could be indicative of seizures; however, the results were normal. Here are additional details: - The episodes seem to be triggered specifically by moving from a crouching or squatting position to standing fully upright, suggesting that postural changes are a significant factor. - They tend to occur at work, where I am usually on my feet for a stretch of time, leading me to wonder if blood pooling in my legs is contributing. - To manage my symptoms, I have started wearing compression socks, increased my sodium intake considerably, and made notable changes to my diet. Overall, I feel that my blood pressure fluctuations and instances of shortness of breath have become more manageable. I am reaching out for input regarding what might be happening. It’s genuinely frightening when these episodes occur. Is it possible that I am experiencing a seizure? Could it be presyncope, dysautonomia, or something entirely different?

Answers (1)

3/23/2025, 10:30:57 PM

OpenHealth AI

It sounds like you’ve been dealing with a variety of complex symptoms that are understandably alarming and frustrating. Your experiences may relate to dysautonomia, particularly given the drop in blood pressure and the episodes you described, which can indeed be related to postural changes. Let’s break this down and focus on what you’re experiencing.

Key Points:

1. Potential Causes: Your symptoms—feeling lightheaded, experiencing tunnel vision, and communication difficulties—could be linked to dysautonomia and potentially presyncope (a near-fainting state). Seizures are less likely given your normal EEG, but it's essential to continue monitoring your situation.
2. Blood Pressure and Postural Changes: The episodes triggered by standing up suggest that blood pooling in your legs could play a role. Dysautonomia often alters how your body regulates blood pressure, especially during positional changes.
3. Managing Symptoms: You've already taken positive steps, like wearing compression socks and increasing sodium intake, which may help with blood volume and pressure.

Next Steps:

1. Continue Lifestyle Adjustments:

   • Stay Hydrated: Drink plenty of fluids to help maintain blood volume.
   • Diet Considerations: Continue managing your sodium intake per your doctor's advice, as this can help maintain blood pressure stability.
   • Use Compression Garments: Continue wearing compression socks when standing for extended periods.

2. Monitor Triggers and Symptoms:

   • Keep a Diary: Track your episodes by noting the time, duration, activities preceding the episode, and any other symptoms. This can help identify further triggers or patterns.
   • Avoid sudden changes in position. When moving from crouching to standing, rise slowly to allow your body to adjust.

3. Discuss with Your Healthcare Provider:

   • Follow-Up: Keep your healthcare provider informed of any changes in your symptoms or new episodes. Since you've experienced episodes similar to presyncope, further discussions may lead to tailored interventions, such as adjusting medications or exploring additional diagnostic tests if necessary.
   • Rule out other conditions: If episodes persist or worsen, consider discussing the possibility of seeing a specialist, such as a neurologist or cardiologist, for a more in-depth evaluation of your blood pressure responses and potential autonomic dysfunction.

4. Self-Care Practices:

   • Manage Stress: Engage in relaxation techniques such as deep breathing, mindfulness, or light exercises. Avoid overextending yourself at work to prevent exacerbating symptoms.
   • Schedule Breaks: If your work involves prolonged standing, ensure you take regular breaks to sit and rest—this can help your body manage blood flow better.

Your experiences sound quite distressing, but you are taking steps in the right direction. Keep communicating with your healthcare provider about your ongoing concerns—your insights are invaluable for tailoring your treatment plan. Feel free to reach out if you need further clarification or have additional questions.