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Avatar universal

Anxiety?

Hi Everyone.  I've posted here once before, but I need some advice.  I'm currently undiagnosed.  

On Thursday morning I woke up and the right side of my face from above my eyebrow to my cheek and down to my upper lip was numb.  Not completely numb, but definitely numb.  I went to work like normal and called my neurologist (who I had previously decided to switch, but decided to give her another try).  My neurologist basically said that she didn't know what was wrong with me, that none of my symptoms made since, and she actually asked "What do you want me to do".  I was doing okay up until this point, but that made me pretty upset.  I went to see the nurse at my office and she told me I needed a new doctor and to go to the ER.  My blood pressure was elevated, but I know that's because I was upset.

So I went to the ER and they got me back pretty quickly.  While I was waiting for the doctor the right side of my face started spasming(The part that was numb), I called my husband and he came up.  This lasted for a while maybe an hour.  At some points my vision was flickering like someone was turning the lights on and off.  When the spasming was really bad my eyes were rolling back into my head and it was hard to concentrate and answer the doctors questions.  There was no spasming in the rest of my body.

Well ER docter called my neurologist and she told him to do a CT of the nerve that controls that part of your face.  The ER doc decided to an MRI which came back normal.  So he called my neurologist back and she told him to write me a prescription for Ativan and send me home and to follow up with her next week.  They didn't do any blood work or run any other tests.

So I didn't fill the prescription.  I started lexapro on Monday because this process has been an emotional roller coaster.  I asked the doctor if my neurologist thought that this might be a side effect of the medicine and he avoided the question and just said that she didn't want me to stop taking the lexapro.

I went home and immediately looked up a new neurologist covered by my insurance.  It's actually the Shands Neuroscience institute here in Jacksonville.   So I called my primary care and asked for the referral which they processed yesterday.  

Just a little background on me, everything started in march with a weird episode of nausea, elevated blood pressure, pain in my arms, and major pain in my chest that made it difficult to breathe, but was relieved with an antinflammatory shot at the hospital.  After that I had pain, numbness, and tingling in my arms, and then pain in legs, occassionally extreme tiredness, diagnosed with optic neuritis in August, and then this most recent incident with pain occassionally in my arms and legs.

I've had an MRI of my Brain with/without contrast and that was normal.  I've had some blood work done as well, but I haven't had a full blood work up since that visit to the hospital back in March.  The only thing that has come back abnormal so far was an elevated CRP.

I'm not going to take the Ativan. I don't need it.  My doctor's basically saying that this may be anxiety.  Does this sound like anxiety?
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147426 tn?1317265632
Okay, if you are still having the facial spasming, and especially if you still have episodes of the eyes pulling back you need to have someone check you and give you something to see if this is an extrapyramidal reaction - which is not a good thing to have.  In the ER they usually use a hefty shot/dose  of Benadryl .  If the spasms stop with the benadryl then it is a med reaction and not a neurologic problem.  Even an Urgent care doc could do this.  You also could take the OTC Benadryl 1 or 2 caps (be prepared to sleep), but I don't know how this would interact with your meds.  You could discuss it with the pharmacist.

I feel this is important and shouldn't wait unless the spasms have lessened or your new neuro appointment is upcoming very soon.

By law and by the code of medical ethics, if your doctor is going to discharge you from the practice they MUST NOTIFY YOU IN WRITING OF THIS INTENT AND AGREE TO PROVIDE CARE FOR THE NEXT 30 DAYS.  By treating you this way, your doctor has effectively committed a form of malpractice.  At minimum this doctor needs a letter of compaint to the state Board of Medical Examiners (or whatever it is called in your state).  You can also call the board and find out exactly what the doctor needs to do and how to formally file a complaint.

Quix
Helpful - 0
Avatar universal
Hi Quix,

Your correct, I started the Lexapro the Monday before the facial spasms started.  I agree with you on the neurologist and your spelling looked fine to me :)  It's difficult to have strange things going on with you and then have you doctor treat you like **** (almost like you're the enemy).

I'm hoping that the new neurolgist that I see will put a little more effort into finding out what's going on.  I'll just keep putting my happy face on and hope for the best.
Helpful - 0
147426 tn?1317265632
Hi, I'll try to talk a little more tomorrow, but what you are probably describing is called "Hemifacial Spasm"and is most commonly seen in people middle-aged and older.  When it is seen in people younger than 40 there should be s search for an underlying neurological disorder.  The most common is MS.

It is caused by malfunction of the 7th Cranial Nerve which controls the muscles of the face.  There is also a condition that is called myokymia, in which the muscles of the face one or both sides appear to writhe - like worms wiggling just below the surface.

Hemifacial spasm and optic neuritis are neither one caused by anxiety, though they both cause anxiety!!!!!!!  Your neruologist is a dim-witted nincompoop!  (I actually never tried to write that before...sp?)

I'm really glad you're headed to a new opinion and I've heard good things about the Shands group - third hand.  

This is not my field of expertise, but it is possible that the twisting of the side of your face and the pulling back of your eyes into your head was a "dystonic" reaction to the Lexapro.  Am I correct in understanding that you started the Lexapro on the Monday before this happened on Thursday?  If so, then it may be a type of reaction called an "extrapyramidal reaction."  The treatment for this is something like Benadryl.  Extrapyramidal reactions which can be as simple as a facial and ocular spasm have been reported with Lexapro, but are not common.  So...if the Lexapro was started before the facial spasms this needs to be considered seriously!  

I really hope you see this.

Quix

Talk later, Quix
Helpful - 0
Avatar universal
I asked for the Lexapro as well.  I really don't want to start a new anxiety medicine at the moment, but I may go fill the ativan just to see if it helps the spasming.  I had the facial spasm again last night.

I keep telling my husband basically what you were saying. Of course I'm going to feel anxiety when these weird things are going on, but that doesn't mean that anxiety is causing them.

I'll keep you posted.

H
Helpful - 0
230625 tn?1216761064
You were diagnosed with optic neuritis a couple of months ago.  Like T-lynn posted, that is not caused by anxiety.

Do get a copy of the MRI report.   I'm sure you know that lesions may be too small to show on an MRI.  You do need other testing, and LP, EVPs, MRIs of your spine, etc.   I hope the new neuro will order those.

As far as anxiety, I suffer from it.   I am on Lexapro due to the increased anxiety due to my health issues as well.   I actually asked for it as I believe that my symptoms may be increased due to the anxiety.  I have had panic attacks in the past and have had tingling in my face, but it was confined to around my lips.  

What dosage are you on?  Is your neuro having you titrate up to the full dosage?   My neuro started me with 5 mg for two weeks, then up to the 10 mg dosage.   I haven't had any real side effects from the med, and certainly none like you've mentioned.    I do find it works very well for me.  It does take 4-6 weeks for you to reach the full effect from the drug.

I hope that the new neuro will get some answers for you!   Please post and update!

Take care!  Pat :)
Helpful - 0
Avatar universal
Its good that you are seeing a new neuro.

Anxiety can have many symptoms related to it,but when undiagnosed it does raise our anxiety levels.

Ativan can be used off label for many things.I take ativan when my nerves get to twitching really bad and it does provide releif.

ON isn't anxiety related that neuro you were first seeing needs womped,you and many others have been labeled by these defective neuro's as anxiety induced symptoms.These DRs need reeducated.

Get a copy of the MRI report,read it for yourself,get copies of the mri and take it to your new neurologist

Please keep us posted.

T
Helpful - 0
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