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Closing eyes tightly and shaking head. No symptoms of headache or vomiting. What is causing this feeling?

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Practicing since : 2007
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My Mother sometimes while sitting just closes here eyes tightly and shooks her head for 2-3 seconds, the expression can be compared to a person cutting onions who cannot bear onions although this is not due to something she is feeling in eyes like onions. Also this happens sometimes. She is NOT doing it frequently may be 7-8 times a day. This has been going on since last 5-6 months. Whenever I ask my mother she says nothing is wrong. By the way she does NOT wear spectacles and her eyesight might be a bit weak also. There is no other symptom like headache or vomiting or anything like that
Posted Fri, 10 Aug 2012 in Mental Health
 
 
Answered by Dr. Sourav Ganguly 1 hour later
Hi,

Thanks for your query.

After going through the detailed description, it seems to be case of tic disorder where person have some voluntary movement in any part of the body like eye, neck .hand, feet, oral muscle etc.) Which last for 2-5 seconds. Just before the movement patient have irritable desire to do the movement and that can give her free from anxiety. So this tic disorder is also an anxiety disorder.

There may be chance of seizure disorder, probably absence seizure where patients become senseless for fraction of seconds, at that time patient become non responsive and usually associated with involuntary body movement like your mother who closes her eyes tightly and shook her head for 2-3 seconds and after seizure attack terminate their occurs total forgetfulness or amnesia of the events. It may be partial or complex partial seizure also.

Last but not the least is that in her age group many patients have early features of dementia and patient can do all kind of involuntary movement in any part of body for any duration and patient totally forget about that due to his dementia. It is also called dementia with behavioural disturbances.

In this old age group any kind of neuropsychiatric manifestations need urgent neuro imaging ( in this case MRI is the best) to know whether any organic causes (like tumor, infarction, ring enhancing lesion, diffuse brain shrinkage, multi infarct dementia etc.) present in the brain and I also advise to do a EEG brain to rule out seizure disorder.

So please consult a Neuropsychiatrist for proper evolution after taking proper history and clinical examination. Above mentioned tests to be done base on his advice and proper treatment should be initiated according to doctor prescription.

Hope I have answered your query. If you have any further questions I will be happy to help
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish you good health.

Thanks,
Dr Sourav Ganguly
Above answer was peer-reviewed by
 
Follow-up: Closing eyes tightly and shaking head. No symptoms of headache or vomiting. What is causing this feeling? 4 hours later
Regarding Dementia, although my mother does have poor loss of concentration but I have NOT noticed any significant short term memory loss as yet. For example the other day I asked my mother about What day and date it was and she was able to tell immediately. Also whenever I ask my mother if she prepared tea a few minutes back she will remember that if she prepared and will tell me that there is still some left in the bowl and I can take it if I want to and she will also tell me that approximately how much time before she prepared the tea like half an hour back or 15 minutes back and whether it is still in drinkable state.

Regarding Tumour, my mother does not have any symptom like headache or vomiting etc. and this eye closing has been going since last 5-6 months.

Shall I still be worried about Dementia or Tumor
 
 
Answered by Dr. Sourav Ganguly 1 hour later
Hi,

Thanks for your query.

I told you that the possibilities of dementia and brain tumour are rare in case of your mother. But as a neuropsychiatrist, we don’t want to miss these rarest possibilities as the prognosis of these two disorders depends on how early we will be able to diagnose them.

In dementia 18%-24% of the patients presented to a neuropsychiatrist in early stage and the only symptoms at that time are involuntary movement of any body part or behavioural disturbances. At that time forgetfulness as so mild that patient relatives fail to identify them. We called them as prodromal symptoms of dementia.

We neuropsychiatrists unfortunately often missed them. In this cases we usually used a scale called XXXXXXX mental state examination (MMSE), Which is a 30 questions scale and by applying the scale we can understand whether she is in early memory impairment or not.

About brain tumour, some symptoms are common like headache, vomiting, vision impairment etc. but in some cases of early brain tumour patient can present with only neuropsychiatric symptoms and during evolution we found a brain space occupying lesion (SOL).

Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish you good health.

Thanks,
Dr Sourav Ganguly
Above answer was peer-reviewed by
 
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