Insights on Seizures and Heart Issues in a Young Male
I am seeking clarity regarding the medical challenges I'm experiencing. I have encountered between five to ten episodes that resemble fainting or seizures, which observers describe as convulsive movements combined with stiffness, though I cannot perceive them myself. These episodes are typically followed by supraventricular tachycardia (SVT), requiring the administration of adenosine on several occasions when my heart rate does not respond to other treatments. Importantly, I have never experienced loss of bladder control or bitten my tongue during these episodes. Moreover, my white blood cell count has been elevated consistently following each incident. After undergoing a Holter monitor test, the results were largely inconclusive, only showing episodes of increased heart rate. My other diagnostic tests, including EEG, CT scan, and brain MRI, all returned normal results. Additionally, I underwent a comprehensive evaluation through oncology and hematology, which also yielded no significant findings. My episodes tend to occur during peak stress moments, both at home and in my academic environment. There is uncertainty regarding the nature of my SVT episodes. I experience agitation and confusion as I recover from them, whereas I generally feel normal while in SVT. Could this imply that they are not true seizures, or perhaps not of an epileptic nature? Such confusion arises because these symptoms manifest every single time. A cardiologist proposed the possibility of vaso-vagal syncope, yet I question how this could account for the observed convulsions. My frustration stems from the lack of definitive answers. I welcome any inquiries from those who comment, as I have undergone nearly every conceivable test, including a tilt table test that also came back negative. Thank you for any insights you can provide.
Answers (1)
3/28/2025, 11:30:41 PM
OpenHealth AI
It sounds like you’ve been through a lot with your episodes, and it’s understandable to feel frustrated and uncertain without clear answers. Your symptoms, including convulsive movements followed by supraventricular tachycardia (SVT) and recovery agitation, present a complex picture that could involve multiple factors. Here, I’ll break down key points and suggest some immediate focus areas.
Key Points:
- Episodes Resembling Seizures: Your episodes could be convulsions triggered by another issue rather than true epileptic seizures, especially since your EEG and brain imaging were normal.
- Heart Rate Changes: The episodes of SVT and the need for adenosine indicate significant heart reactions but are not in themselves diagnostic of a particular cause.
- Potential Triggers: Stress seems to be a recurrent factor, which can exacerbate both heart and neurological symptoms.
Explanation:
Your symptoms could arise from a few different conditions:
- Psychogenic Factors: Stress and anxiety can lead to conversion disorder, where physical symptoms present in response to emotional stress without a neurological basis.
- Vasovagal Syncope: While your cardiologist mentioned this possibility, typically, fainting episodes do not include prolonged convulsions.
- Other Cardiovascular or Autonomic Dysfunctions: These could cause the heart rate changes and may involve unrecognized or subtle triggers during stress.
Next Steps:
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Track Your Episodes: Keep a detailed diary noting the time, triggers (like stress), symptoms, duration, and recovery phases of each incident. This can help you and your healthcare team identify patterns or additional triggers.
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Stress Management Techniques: Consider implementing relaxation strategies like deep breathing exercises, mindfulness, or yoga. These have been shown to alleviate stress and may reduce the frequency of episodes.
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Follow-Up on Vaso-Vagal Syncope: Since this possibility has been suggested, discuss with your cardiologist if further evaluation or treatment tailored to this condition is warranted, especially focusing on physical countermeasures, such as increased fluid and salt intake, which can sometimes help manage symptoms.
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Revisit with Specialists: If episodes persist, consulting with a neurologist who specializes in non-epileptic seizures or a psychologist might help clarify if there is a psychological component.
If at any point your episodes worsen, or if you experience new symptoms such as severe headaches or loss of consciousness, seek immediate medical attention. Your health journey can be overwhelming, but these steps may help provide clarity and alleviate some frustrations. Please feel free to reach out if you need more specific guidance or support regarding any part of this process.
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