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I don't know if my symptoms are real or the

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Posted on Tue, 2 Apr 2019
Question: I don't know if my symptoms are real or the result of a panic attack. My left arm feels very heavy and the left side of my face is tingling...
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Answered by Dr. Dariush Saghafi (2 hours later)
Brief Answer:
Panic attacks often not associated with unilateral symptoms in the body

Detailed Answer:
Thank you for your question.
I'm sorry you're feeling this way right now but here's what you should consider.

First and foremost....you're very young to be having things such as strokes or heart attacks.....unless you've got a significant family history or have ridiculous numbers of risk factors that are out of control. So, I think just on the basis of that alone....you stand a very good chance of having symptoms NOT RELATED necessarily to one of those bad players.

Having said that, many young people actually do end of having things such as heart attacks, strokes, and other calamitous events because of unexpected blood clots, use of drugs such as oral contraceptive pills who are concomitant smokers (places a young person at a high risk for bleeds in the brain, etc.), use of illicit drugs such as cocaine and other high powered and dangerous drugs/medicinals.

Let's look at a PANIC attack. Typically, these are taken to be the sudden and unexplained onsets of INTENSE FEAR or discomfort that evolves rapidly and includes at least 4 of the following symptoms: Palpitations, pounding heart, or accelerated heart rate. Sweating. Trembling or shaking. Sensations of shortness of breath or smothering. There is an overwhelming sense of DOOM AND GLOOM. They usually do not include the development of FOCAL neurological deficits over half the FACE or an extremity and especially not SIMULTANEOUSLY over the same side of the body. Another way to explain a panic attack is to imagine a SUDDEN AND INEXPLICABLE feeling of IMPENDING DISASTER which comes from no particular event or reason....it just COMES on. The episode is LESS than 30 minutes in duration and can occur in flurries within the same short period of time.

My best advice to you at this point is to GO TO THE EMERGENCY ROOM right away and get checked out...especially if your symptoms have been present for GREATER than 30 min. and the symptoms are still present. As a neurologist my first instinct is always to have patients present to an emergency room in these types of situations and to be IMMEDIATELY worked up by a physician who is familiar with stroke in the young and to rule this out as quickly as possible before entertaining anything beyond that such as PANIC, ANXIETY, or SOMATOFORM disorders since the latter doesn't leave you with permanent irreparable damage whereas the former just may if something's not done quickly to assess and intervene on the patient.

Even if your symptoms have subsided from when you first wrote this question.....I would still want you to go to the ER and get some type of an examination by a physician, get an imaging study of the brain, and then, be told that they couldn't find anything but to follow up with a NEUROLOGIST as soon as possible.

So, now young lad....please make a phone call to the Emergency Squad services and have them take you into the hospital if you are still having any residual symptoms...right this instant, please... If the episode passed and you are feeling perfect back to normal then, still I want you to make your way (preferably someone can drive you or you can catch an UBER or LYFT) to the nearest EMERGENCY ROOM so you can be immediately checked.

If they'll do what's called an MRI with perfusion and diffusion-weighted imaging they will see residuals of what may have been a temporary blockage of a small vessel feeding the RIGHT UPPER CONVEXITY OF THE BRAIN....that activity can be seen for hours after an event.

Please hop to it son and don't second guess yourself on this....it's important. And let me know how you did and what they found.

Now, what follows below is what I'd like you to do once returned from Emergency Services...GO now...you can read below later......just get some clothes on, get someone to drive and snap to....off you go!

If I've provided useful or helpful information to your question could you do me the utmost of favors in not forgetting to close the query along with a few POSITIVE words of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi

You can always reach me at that address for this or other questions. I wish you the best with everything and hope this information does help you.

This query required 36 minutes of professional time to research, assimilate, and respond in complete form.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

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I don't know if my symptoms are real or the

Brief Answer: Panic attacks often not associated with unilateral symptoms in the body Detailed Answer: Thank you for your question. I'm sorry you're feeling this way right now but here's what you should consider. First and foremost....you're very young to be having things such as strokes or heart attacks.....unless you've got a significant family history or have ridiculous numbers of risk factors that are out of control. So, I think just on the basis of that alone....you stand a very good chance of having symptoms NOT RELATED necessarily to one of those bad players. Having said that, many young people actually do end of having things such as heart attacks, strokes, and other calamitous events because of unexpected blood clots, use of drugs such as oral contraceptive pills who are concomitant smokers (places a young person at a high risk for bleeds in the brain, etc.), use of illicit drugs such as cocaine and other high powered and dangerous drugs/medicinals. Let's look at a PANIC attack. Typically, these are taken to be the sudden and unexplained onsets of INTENSE FEAR or discomfort that evolves rapidly and includes at least 4 of the following symptoms: Palpitations, pounding heart, or accelerated heart rate. Sweating. Trembling or shaking. Sensations of shortness of breath or smothering. There is an overwhelming sense of DOOM AND GLOOM. They usually do not include the development of FOCAL neurological deficits over half the FACE or an extremity and especially not SIMULTANEOUSLY over the same side of the body. Another way to explain a panic attack is to imagine a SUDDEN AND INEXPLICABLE feeling of IMPENDING DISASTER which comes from no particular event or reason....it just COMES on. The episode is LESS than 30 minutes in duration and can occur in flurries within the same short period of time. My best advice to you at this point is to GO TO THE EMERGENCY ROOM right away and get checked out...especially if your symptoms have been present for GREATER than 30 min. and the symptoms are still present. As a neurologist my first instinct is always to have patients present to an emergency room in these types of situations and to be IMMEDIATELY worked up by a physician who is familiar with stroke in the young and to rule this out as quickly as possible before entertaining anything beyond that such as PANIC, ANXIETY, or SOMATOFORM disorders since the latter doesn't leave you with permanent irreparable damage whereas the former just may if something's not done quickly to assess and intervene on the patient. Even if your symptoms have subsided from when you first wrote this question.....I would still want you to go to the ER and get some type of an examination by a physician, get an imaging study of the brain, and then, be told that they couldn't find anything but to follow up with a NEUROLOGIST as soon as possible. So, now young lad....please make a phone call to the Emergency Squad services and have them take you into the hospital if you are still having any residual symptoms...right this instant, please... If the episode passed and you are feeling perfect back to normal then, still I want you to make your way (preferably someone can drive you or you can catch an UBER or LYFT) to the nearest EMERGENCY ROOM so you can be immediately checked. If they'll do what's called an MRI with perfusion and diffusion-weighted imaging they will see residuals of what may have been a temporary blockage of a small vessel feeding the RIGHT UPPER CONVEXITY OF THE BRAIN....that activity can be seen for hours after an event. Please hop to it son and don't second guess yourself on this....it's important. And let me know how you did and what they found. Now, what follows below is what I'd like you to do once returned from Emergency Services...GO now...you can read below later......just get some clothes on, get someone to drive and snap to....off you go! If I've provided useful or helpful information to your question could you do me the utmost of favors in not forgetting to close the query along with a few POSITIVE words of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi You can always reach me at that address for this or other questions. I wish you the best with everything and hope this information does help you. This query required 36 minutes of professional time to research, assimilate, and respond in complete form.