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Dr. Andrew Rynne

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What causes rapid heart rate, excessive sweating and breathing difficulty?

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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3418 Questions

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Posted on Wed, 8 Mar 2017 in Brain and Spine
Question: 



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Dr. Erion Spaho
Neurologist, Surgical

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hello

dear dr 

iam a dentist
so you can explain to me in the way that you like

first 

feb.2016

i was going to sleep, then i get up after 30 min, i couldnt sleep. rapid heart rate. little sweat.i was nervous start to walk at home . then i couldnt breath well. i fall down hit the floor with my head. get up after 1 minute.. i went to hospital, i thought it was aheart attack, i did all tests, every thing was normal.

after that i start to do more test
heart stress test
heart echo
all was good

i did then a brain ct scan.. dr said u have. there is little sign of prominant temporal lobe at temporal horn and he asked for mri

i didnt do it that time,
then .. i feel normally

till

october 2016

after 8 months

same thing happened

i got up ,, feeling like am.dying or my soul is going out, fast heart rate, little spasm at my left hand, no chest pain , shaking i called 777 its like 911 in us.
they came and they took me to hospital 
they did all test
heart ecg .. normal
bleed tests
normal

no signs for stroke
i went home

next day it happened the same time . 3 am
again called 777 pulse temp suger all normal


i did ear throat test normal
nose test normal

i start to go for a dr he asked for more tests kidney liver etc etc all was normal.

he told me its a panic attack u should control it .

i did

but it happened again but this time i controlled it 
i didnt call ambulance but next day there was a headache and i was so tired .

so decided to do the MRI
i did it 
few days ago
the result at the attachment
but note that i dont have any signs of seizure

it happened again with me yesterday , the issue is im feeling tired and upset i want to know whats happenening with me

im controlling this , but its hard,

i have no pressure and im not diabetic 

thank you

thank you
doctor
Answered by Dr. Olsi Taka 3 hours later
Brief Answer:
Seizure or panic attacks....would favor seizure possibility.

Detailed Answer:
I read your question carefully and I understand your concern.

Judging from your description and that MRI report I would say that the two main possibilities in your case would be either seizures for which you may have a predisposition given the hippocampal atrophy or simply a case of panic attacks as it was suggested to you.

Perhaps you are more familiar with the concept of seizures as episodes where you lose consciousness and have convulsions. However there are many types of seizures depending on where do the electrical discharges happen, they may be focal and cause only partial seizures without losing consciousness, manifesting even with anxiety as this case. Actually temporal lobe seizures (where the hippocampus is found) may manifest precisely that way and the hippocampus is a region very commonly associated with seizures.

How to differentiate between those possibilities....an EEG may help at times. It has value only when confirming epileptiform activity though, it doesn't exclude the diagnosis as between episodes EEG may be normal in half of the patients. Repeat EEGs have a greater chance of detecting something, but still do not exclude epilepsy.
Apart from the EEG the distinction lies mainly in the clinical manifestations of the episodes. As I said the distinction is difficult because seizures may manifest with anxiety but in your case I am more in favor of the seizure possibility. That is because you mention that spasm in your left hand only which would coincide with that right hippocampal finding. If it was anxiety spasms would have been on both sides. However I would repeat EEG before starting treatment.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 3 hours later
thank you dr foe your replay, please a another ques, if this seaizure, why it only happen while am.sleeping between 3 am and 4 am . i never happened while im awake, i always was sleeping and get up with this.
i will do more eeg
thank you
doctor
Answered by Dr. Olsi Taka 4 hours later
Brief Answer:
Can happen

Detailed Answer:
The fact that it happens only during sleep is actually a common finding in epilepsy, it is a well known phenomenon in many patients to have seizures only in sleep. The mechanism is not well understood, it is thought to be due to being more predisposed to seizures during changes in sleep phases (in sleep we undergo cycles which are separated in phases where brain activity changes from one phase to the other).
So it is not an argument against seizures at all, actually would be something to sway balance more in the direction of a seizure (though panic attacks may happen at night as well, is not a differentiating factor).

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 11 minutes later
many thanks to you , you answer is very usefull. i will.update you later with my situation . thank you
doctor
Answered by Dr. Olsi Taka 4 hours later
Brief Answer:
Hope things work out for the best.

Detailed Answer:
Glad to have been of help. Hope things work out for the best.
Above answer was peer-reviewed by : Dr. Kampana
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