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Generalized anxiety disorder, tremors. Are my symptoms psychological? Do I need an MRI?

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I'm a 22 year old male from the Philippines. (Height: 5' 8.5", Weight: 120 Pounds). I was recently admitted to the hospital because of a bacterial infection that caused my White Blood Cell Count to rise to 17,000. At the hospital, my fever shot up to 39.8 Celsius and my blood pressure to 170/100. My blood pressure spiked to that level, as I got anxious thinking that I might die, as my fever did not subside even with Paracetamol. So that I could relax, the doctor in charge had to give me Benadryl. 20 minutes after drinking Benadryl, I forced myself to sleep and my body was vibrating. With eyes shut, I was hallucinating that my body (excluding my head) was exploding. Even with Benadryl inside my system, I compelled myself to wake up and eat dinner. That was when I noticed that my left arm was in pain. While it was not an excruciating pain, it throbbed to the point that I, again, got agitated. Immediately thereafter, while the pain was searing through my left arm, I forced myself to sleep. I then woke up five hours later; my body was trembling and I had to call the nurse to monitor my blood pressure. It was 150/100.

When I was discharged from the hospital, I was on edge and very anxious. The night that I was discharged, I remember waking up and feeling confused. I was at a loss thinking about what I forgot as my memory was not working as it should. Again, I was trembling and panicking, but not to the level of panic that I felt at the hospital. When I regained my composure, I recovered my memory and tried hard to sleep.

I woke up the day after feeling disoriented. My balance was off. I could walk, but I had to drag my feet sideways, as my head felt heavy. My eyesight, while not blurred, was also not fine. Things were brighter, the clouds were whiter, and my vision was a little hazy. My eyes became more sensitive. I also felt colder. It was as though the body hair on my arms and legs were not reacting. Hence, it felt cold, although my threshold to low temperature was on the upside before the incident. I was a mess.

That night, my mom had to give me 250 mg of Xanax, as I was again shaking and felt very nervous. 20 minutes after, my thighs felt like lead and were very heavy. Upon waking up, I realized that I developed a urinary retention problem.

Because of these episodes, my mom and I had to consult the psychiatrist. The psychiatrist maintained that all these episodes were brought about by my panic attacks. I was diagnosed with generalized anxiety disorder and panic disorder and was put on Xanax for 2 weeks and Jovia for 6 months. We also went to the cardiologist. EKG and Echocardiogram results were fine. Likewise, we headed to the ophthalmologist who reassured me that there was nothing to worry, as my vision was normal, save for a slight case of astigmatism which would be gone after a week. On three separate occasions, we also consulted with two neurologists who performed basic neurological exams and evaluated that my coordination and reflexes were good. Thus, they insisted that there was no need for further tests, such as the MRI.

Now I'm writing, as it has been three weeks since my hospitalization and I'm still feeling a bevy of residual sensations, thereby troubling me deeply. Here they are:
(1). twitches on several parts of my body, especially when I'm resting or sleeping. I have had twitches three years back. However, they were not as bothersome as they are now after my hospitalization.
(2). tremors (hands, feet, back, head). The head tremors come and go.
(3). strange vibrations (feet)
(4). pins and needles (several parts of my body)
(5). a strange pain at the back of my head. It feels as though there's pressure inside of it. It's only a faint pain and only lasts for a few minutes. I don't need to take any medicine for the pain, as it's bearable and disappears when I tilt or nod my head.
(6) sore thigh muscles when doing squats or bending, since I had my first brush with Xanax
(7). back and knee pains
(8). frequently cracking/popping joints especially on my knees and shoulders.
(9). light sensitivity
(10). heat sensitivity
(11). frequent yawning and hiccup with tremors
(12). balance issues
(13). poor coordination

Prior to my hospitalization, I dealt with some strange issues with my body, which I all attributed to my high level of anxiety and stress. These are:
(1). palatal and diaphragmatic myoclonus
(2). head pressure especially when waking up and doing stretches
(3). almost daily twitches (especially when resting)
(4). clicking at the back of my head
(5). migraines that can last for a month (For most of the time, I’ve endured through these terrible migraine attacks without any medicine)
(6). ear pressure when swallowing.
(7). Restless leg syndrome

Now I'm really confused as to whether all of these symptoms are psychological. Do I need to have an MRI scan to put these issues to rest once and for all? Are any of these symptoms alarming to warrant a third opinion from another neurologist? I’ve been assured by my doctors time and again that I have nothing to worry about. Nevertheless, these past few weeks have taken quite a toll on my well-being, as even simple activities such as counting money have left me frustrated, since my arms and legs are trembling and vibrating to no end. I certainly am hoping that I don't have Multiple Sclerosis (and that I didn't have a Transient Ischemic Attack) and I'm just being my usual worry-wart self in the midst of it all.

Thank you.
Posted Thu, 19 Apr 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 5 hours later

Thanks for the query.

Regarding the current problems in you as listed above; I personally feel it is not Multiple Sclerosis. All these look to me more as psychological rather than organic disease. I do agree with your neurologist opinion. MRI (Magnetic Resonant Imaging) is not going to solve your problem as it likely to be normal in you.

So I personally feel you need to be in touch with your Psychiatrist and clinical psychologist for regular counseling and follow up. You do not require further evaluation from neurological point of view.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.

Please accept my answer in case you do not have further queries.


Dr Shiva Kumar R
Above answer was peer-reviewed by
Follow-up: Generalized anxiety disorder, tremors. Are my symptoms psychological? Do I need an MRI? 3 hours later
Thanks Doctor.

Can I expect complications to develop from my palatal and diaphragmatic myoclonus in the future? Pls advise.

Answered by Dr. Shiva Kumar R 17 hours later

Thanks for reverting.
Palatal and diaphragmatic myoclonus do not cause any serious complications. Palatal myoclonus can cause clicking or popping in the ear which persists in sleep. Diaphragmatic myoclonus can cause hiccoughs. These conditions do not have any long term complications and should not be a cause of undue anxiety.


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