OpenHealth Q&A

Seeking Clarity on Unexplained Episodes

For some time now, I have been experiencing strange episodes, and I’m uncertain about their true nature. While I suspect they might resemble seizures, there’s also a possibility that they could simply be instances of syncope. I’m currently prescribed the following medications: Methylphenidate, Guanfacine, and Fluoxetine. As for my physical statistics, I stand approximately 5 feet 3 and a half inches tall and weigh around 131 pounds, although I usually don't keep track of my weight precisely. Before detailing the nature of these episodes, I’d like to mention a couple of potential triggers: - Stretching, especially just after waking up. - Occasionally standing up too quickly. The stretching is particularly perplexing, as it’s uncommon for seizures to be triggered by such actions. I’ve undergone testing for POTS multiple times, all yielding negative results, and there are no known cardiovascular issues affecting me. The occurrences themselves are unpredictable; sometimes I can stretch with no aftereffects, while other times, the results are quite different. Here's how I would characterize the episodes, ranked by severity: **Mild:** These episodes tend to be minor appearances, with a few variations: - I may experience dizziness, a wobbly feeling, and some twitching or jerking of my arms. - Another variation involves similar sensations without the dizziness. - A slight instance of dizziness might occur, accompanied by a blank stare and a sense of my body going limp. - A variant of the last point, but here my body remains rigid while my hands convulse. In all cases, I remain fully conscious, though I feel peculiar afterward—almost like a déjà vu experience, but in reverse. **Moderate:** Slightly more intense than the mild instances: - These can induce a fading in and out of consciousness, although I remain aware enough to comprehend my surroundings. - There are occasional grunts, despite them being uncommon for me. - I sometimes find myself biting the inside of my left cheek only. - My upper body might twitch or jerk significantly, leading to either falling down or going limp if I’m seated. If I’m upright, I may stiffen and fall backward, alongside other convulsive actions. During some of these episodes, I can still stand and maintain some level of consciousness, alternating between fading out and full awareness. **Severe:** Although these might not appear severe to outside observers, they are quite significant for me. These typically occur when moderate episodes escalate: - There’s a complete loss of consciousness, or I teeter on the brink of it. - I often feel quite unsteady afterward, accompanied by headaches. - The convulsing is similar to the moderate instances but generally worse. - I tend to grunt during these episodes. - There are times when I’ve bitten my cheek so hard that it has bled. While I don’t encounter these regularly, they warrant mention. On average, I have about 4 to 7 episodes daily, sometimes even more depending on the day. Despite their severity, I can generally resume normal activities without issue, which fuels my uncertainty. These episodes last anywhere from 2 to 15 seconds. A notable incident occurred when a friend witnessed one—though I was unconscious, my eyes remained open, leading to a rather peculiar description that likened me to a bug that continues to twitch after being crushed. At this point, I am still unsure about whether these episodes qualify as seizures, and I do not believe I have epilepsy. However, I am scheduled for a neurologist appointment in six days to seek further clarity. As an added note, these episodes are more of an inconvenience than distressing; I've been living with them for about a year now.

Answers (1)

7/9/2025, 12:31:02 AM

OpenHealth AI

It sounds like you're experiencing a series of concerning episodes that could be related to either seizures or syncope, and it's understandable to want clarity on what you're experiencing. You have a scheduled appointment with a neurologist, which is a crucial step in determining the nature and appropriate management of these episodes. Here’s a breakdown of your situation and some actionable guidance.

Key Points:

1. Understanding Your Episodes: The symptoms you describe—varying degrees of consciousness, movements, and feelings of déjà vu—could suggest a range of conditions, including seizures or other neurological/vasovagal issues.
2. Potential Triggers: Activities like stretching or standing up quickly are known to provoke episodes in certain individuals, which adds complexity to your case.
3. Importance of Neurological Evaluation: A neurologist will be best equipped to evaluate your symptoms through physical examinations, medical history, and possibly additional tests, to provide clarity on whether these are seizures, syncope, or another condition.

Explanation:

Your varied symptoms and the response to triggers suggest a need for detailed neurological assessment. It is beneficial that you’ve noted the characteristics and frequency of your episodes; this information will be very useful for your healthcare provider.

Since you’re currently on medications like Methylphenidate, Guanfacine, and Fluoxetine, it's important to consider how these may interact with your symptoms.

Next Steps:

1. Document Your Episodes: Keep a detailed diary of when the episodes occur, their duration, associated activities (like stretching or standing), and how you feel before and afterward. This will help your neurologist understand the patterns.

2. Prepare for Your Neurologist Appointment:

   • Write down your full medical history and list any changes in your symptoms.
   • Note any specific triggers you’ve identified.
   • Compile a list of your medications, including dosages and any side effects you’ve experienced.

3. Monitor Symptoms: While waiting for your appointment, try to avoid sudden movements and be mindful of stretching, especially upon waking, to see if you can reduce the occurrence of episodes.

4. Stay Calm and Informed: It’s understandable to feel uncertain and to want answers. Reassure yourself that seeking a professional opinion is the right step, and be prepared to discuss everything openly with your neurologist.

5. Emergency Plan: Make a plan for what to do if an episode occurs, especially if there is a chance of falling or injury—consider informing those close to you about your experiences and when to seek help.

Your proactive approach will serve you well as you navigate this situation. Please reach out if you have more questions or need further support while you await your appointment.