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Suggest Treatment For Episodes Of Shivering And Jerking

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Posted on Wed, 29 Oct 2014
Question: I have experienced a number of episodes of very
sudden onset violent shivering, to the point of jerking, followed swiftly by a high fever (103-104 & my normal at my doctor's office is around 97). This has only happened at night, once immediately followed a deep thrust during sex. The other times it just happened out of the blue. It's gone by morning & always is accompanied by abdominal pain. I can't be more specific than that as I get "out of it" pretty fast during the episodes. I have suffered from constipation since birth. Any ideas?
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)
Brief Answer:
needs workup to differenciate rigor from seizure

Detailed Answer:
Hello and Welcome

I appreciate your concern.

I have read your history carefully. The violent shivering episodes are not normal and require further work up before a final diagnosis is reached.

The initial investigations should focus on ruling out or confirming

a) Seizures / epilepsy
b) Rigors/ chills due to an infective cause eg Pneumonia
c) Panic attacks

In a seizure , after the episode, there is associated elevated temperature, tongue bite and /or urinary incontinence.

The raised temperature and abdominal pain which you complained of , can occur due to the violent shaking and muscle fatigue.

The investigations should include the following in consult with your doctor.

Full blood count, urea and electrolytes, Chest X ray.
erythrocyte sedimentation rate / C-reactive protein, and liver function tests
Blood cultures
Urine for microscopy and culture

If an infective cause is not found then an EEG can be done.
Blood sugar and electrolyte abnormalities should also be looked for to rule out any metabolic cause.

If the above investigations are normal I would suggest you to consult a psychiatrist so that a XXXXXXX mental state exam is performed to ascertain depression and or anxiety to rule out the possibility of a panic attack. A panic attack can very well present in the same way.

Hope this helps.
Let me know if you have any query

wishing you best of health

Thanks
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Suggest Treatment For Episodes Of Shivering And Jerking

Brief Answer: needs workup to differenciate rigor from seizure Detailed Answer: Hello and Welcome I appreciate your concern. I have read your history carefully. The violent shivering episodes are not normal and require further work up before a final diagnosis is reached. The initial investigations should focus on ruling out or confirming a) Seizures / epilepsy b) Rigors/ chills due to an infective cause eg Pneumonia c) Panic attacks In a seizure , after the episode, there is associated elevated temperature, tongue bite and /or urinary incontinence. The raised temperature and abdominal pain which you complained of , can occur due to the violent shaking and muscle fatigue. The investigations should include the following in consult with your doctor. Full blood count, urea and electrolytes, Chest X ray. erythrocyte sedimentation rate / C-reactive protein, and liver function tests Blood cultures Urine for microscopy and culture If an infective cause is not found then an EEG can be done. Blood sugar and electrolyte abnormalities should also be looked for to rule out any metabolic cause. If the above investigations are normal I would suggest you to consult a psychiatrist so that a XXXXXXX mental state exam is performed to ascertain depression and or anxiety to rule out the possibility of a panic attack. A panic attack can very well present in the same way. Hope this helps. Let me know if you have any query wishing you best of health Thanks