Is dizziness, nausea and anxiety a sign of epilepsy?

Posted on Mon, 3 Mar 2014

Question: Hello: I have queried you before - in October. I am recently diagnosed w TLE, am 74yr old woman. I have 2 examples that I think must be seizures but I am uncertain bc they both have content. 1. I am on XXXXXXX crowded bus. A young man with a powerful speaking voice seems to take up all the space in the bus -- is dominating young women by pretending to interview them. Overhearing all this my ears screeched and my stomach turned to the point of nausea. I was dizzy and anxious but I stayed on the bus. That is it. Example 2 Walking along a street, suddenly extreme terror and intense ripping, as if a razor was ripping my torso apart. I was so afraid of falling down on the sidewalk. But then I thought that it was because my neurologist, whom I recently fired, would tell my upcoming neurologist that I am a liar and do not really have epilepsy - that I am a fake. I felt that if that happened I would not survive it. This took less than a minute though I recovered all day. [In other words, there is a psychological element so the question is whether a seizure can be a seizure even so?} I was afraid of the neurologist who appeared to loath me. I also want to mention that from the time I queried you in October to now, I have never been clear about whether I have had any seizures, though I have many experiences that point in that direction.

Answered by Dr. Manisha Gopal (13 minutes later)

Brief Answer: appear to be relates to stress & not seizures Detailed Answer: Hello and welcome to HCM! Your symptoms apper to be due to sever anxiety more than due to seizures ( so there is a psychological factor associated with them). Both the times you have a thought / a situation of stress when you developed the symptom. One my however differentiate it objectively from a seizure episode or anxeity by - 1. getting an EEG or 2. testing for serum prolactin leves within 24 hours of the episode ( it will be raised in seizure ) You have not metioned if you taking any medication for anxeity / depression. I think that you should see a doctor, preffrably a psychiatrist and discuss the symptoms in detail. you need to take a medicine ( like - sertraline or escitalopram ) to relax your thoughts and fears ( this will help you a lot, and even help your high blood pressure). The above mentioned tests will clear your doubts about the long standing dellima of seizure. Once the test come normal, I have seen such episode responding very nicely to etizolam or clonazepam in a dose of 0.25 to 0.5 mg. hope the reply is useful Wish you good health! feel free to ask more questions for clarification Dr. Manisha Gopal MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Gopal (49 minutes later)

Dr XXXXXXX Thanks for your reply. I never have heard of having serum prolactin levels tested. It is important that I know about it. I have also never had anxiety that has manifested itself in these ways. And it is true that I have never before had a doctor who terrified me. These two episodes refer to him and our interactions -- I can now see that clearly. I have been trying to find a psychiatrist who is not in the health delivery system of which I am a member. This turns out not to be so easy but your answer is inspiring me to work at it harder. Again, thank you very much. You may hear from me again.

Answered by Dr. Manisha Gopal (14 minutes later)

Brief Answer: Remember, understanding is healing! Detailed Answer: Hello, I am happy to know that the reply was useful and informative for you. I should tell you that symptoms like yours are commonly seen in everyday clicnical settings. The only difference is - that we have to try hard to make the patient realise that it is related to anxiety and not organic ( seizure ) but you are sensitive and conscious enough to understand it. "Understanding is also a form of healing". From now you will see that the attacks will reduce in intensity or might not come ever again. So, try to relax in such situations by focussing on your breaths, breathe slowly and exhale for more duration than inhalation ( about twice to inhaling). I am sure that you will be able to move forward! Good luck If you are satisfied, please rate the answer and close the query. If there are more question, I will be pleased to answer them Dr. Manisha Gopal MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar