What does trembling sensation while waking up when diagnosed with epilepsy suggest?

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Posted on Sat, 6 Jun 2015 in Brain and Spine
Question: Hi this is my third question and I'm sorry to bother you but am concerned. If you read through my last progress notes you'll see i have been working with a neurologist who in addition to putting me on keppra and scarring me with her diognosis of epilepsy, although i have never had a seziure, had her M.A call with genetic test results that were done to check for elors danlos syndrome. The test showed evidence of a genetic mutation but one that is not consistant with muscular distrophy. So what does this mean and how do i find out what type of mutation i have and does it matter. I suppose everyone has something but some are more serious then others. I am tired of tests, and am seeking a second opinion on the eeg results on the 26th. I went through XXXXXXX diognostics. How do i find what mutation i have or will it forever remain a mystery, and if so, should it remain unknown. I'm still symtomatic and in the mornings wake with an internal tremble that subsides within ten min. Please advise.
thank you, XXXXXXX
doctor
Answered by Dr. Ajay Panwar 14 hours later
Brief Answer:
Please upload genetic tests results/EEG report.

Detailed Answer:
Hi,
Thanks for being on healthcaremagic.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your previous two queries and based on your questions,I want to clarify some points here-
1)Seizure is not necessarily a convulsive activity,where tonic clonic activity occurs.Complex seizures can be of bizzare forms.Even the feeling of internal tremble,as you said,may be a seizure.Or,it may not be as well.Video EEG actually detects,whether there are abnormal electrical discharges in the brain at the time when your body is having an abnormal activity like internal tremble(as you mentioned).So,seizures just can't be negated here.If you are having an abnormal body activity episodically,seizure is a differential diagnosis.So,please describe well what happens with your internal trembles or episodes.?
2)Keppra is not the only antiepileptic drug.If it is causing behavioural abnormalities,it may be switched to some other effective antiepileptic drug.
3)EEG is not 100% diagnostic but a definitely useful supportive investigation.
4)Please upload your EEG and genetic test results as scanned images.With the genetic test results,I shall be able to tell you better about the details of the mutation detected.

Waiting for your follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar 14 hours later
Hi Dr. Panwar,
It will take about a week or so to recieve my results on papper. I need to go in and sign a release to obtain them and i will be seeing a neurologist for a second oppinion on the 26th. It's not all the time but some days i feel a tremble upon waking up. I also have muscle spasms, and occasionally a strangling sensation and numbness inmy left arm. I have not had a seziure but at times feel foggy and extreemly fatigued, but that could be the virus running it's course. The most concerning thing to me is that my last neurologist did not take me seriously about dealing with depression from being hospitalized and housebound for so long and when i sugessted a gentler drug then keppra she refused to discuss it. As a result i had suicidal ideation and i think a slight break. I am normally a very jovial pleasent person and it completely changed me, which in turn broke my trust with her. I also have tachycardia and pvcs that are erratic. Somedays im within NL and others my heartrate is around 140 standing 105 resting. Could sezuires cause heart arrithmia? I really wish I never knew about seziure activity because it induces so much anxiety. I am taking 1 mg clonopinat bedtime but feel as though my heart has been having more palpatations since. I'm just super concerned and afraid all the time. When i get my records i will pass them on but if you could break down some of this for me I would greatly appreciate it. What are some classic symptoms that could present for a partial seziure disorder and why now at 39?
Thank you, XXXXXXX
doctor
Answered by Dr. Ajay Panwar 17 hours later
Brief Answer:
Seizure may cause transient arrhythmias.

Detailed Answer:
Hi,
Thanks for being in follow-up and providing details.
Sure,I'll be waiting for the genetic test results and EEG.Please upload them as soon as you receive.

I can understand the mental harrassment,you have been through.If your treating doctor is not behaving well,the answer is straight and simple-change the doc.Its not a big issue,switching Keppra to some other antiepileptic drug. Infact,you had suicidal tendencies,that is an absolute indication to change Keppra to some other antiepileptic drug.Meanwhile,please continue clonazepam for anxiety.

Seizure,of course,can cause cardiac arrhythmias.But,these are usually transient and not of severe or life-threatening nature.Please consult a cardiologist regarding this and undergo a 24 hour ambulatory ECG monitoring,so as to detect the actual nature of cardiac rhythm disturbance.

Seizure is not just a convulsive tonic-clonic activity.A partial seizure can manifest in multiple forms like paresthesias(abnormal sensations),vision disturbances(flashing lights or hallucinations),vertigo or sensation of falling,flushing,sweating,piloerection,alterations in hearing or smell,psychic symptoms,sensation of intense odors like burning rubber or kerosene or an epigastric sensation that rises from stomach to the head.These symptoms come in episodes.

Hope that I have answered your queries pointwise here.I suggest you to please be reassured,as even if these are seizures,they are well treatable.

If you have no further queries,please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)


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

Neurologist

Practicing since :2007

Answered : 1794 Questions

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