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Neurology (Expert Forum)
Anxiety or something worse?
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Anxiety or something worse?
by Cook323, Nov 03, 2009 09:30AM
I have been experiencing some strange feelings within the last six months. After going to my internal medicine doctor and having him perform all of the blood work needed to rule out any underlying conditions, he has referred me to a neurologist. Unfortunately, I can't get into see her for almost a month because she is booked. I have had a few episodes where I feel like I am unsteady on my feet and and have to hold on to something. It's almost like a feel like I do not have enough oxygen getting to my brain. I know it sounds absurd but there was an incident when I was driving and i had to pull over with my three kids in the car. That makes me nervous. I get sweaty and uptight when I have to drive too far of distances for fear that something may happen. I wake up just not feeling like myself, like I am on a ton of caffiene where I have totally cut out coffee for fear of feeling this way. I feel like I am in a fog. I guess if it is anxiety, then I will do what it takes to cure it, medication or any other means of controlling it. But if it is an underlying physical condition, like something in my brain or a nerve disorder, I want to get to the bottom of it. I am at a loss of what to do and I guess I just have to wait and see what the doctor says in almost a month:( Any suggestions?
Doctor's Answer
by Lama Chahine, MD, Nov 07, 2009 10:00AM
, Nov 07, 2009 10:00AM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
It sounds like you have been having some unsteadiness, and a sensation of "fogginess". These, as described above, are nonspecific and could be due to a variety of causes.
In general, unsteadiness on the feet can result from many different causes, including a problem in the nerves in the arms and legs (what is termed a neuropathy), a problem with the spinal cord (what is termed a myelopathy), a problem with the part of the brain that coordinates our movements (called the cerebellum). Sometimes, no specific cause is identified, and all that is needed is some physical therapy and conditioning. Without more information, it is difficult to provide you with more information about your unsteadiness, but a thorough physical examination by the neurologist will help differentiate all these various causes, with possibly additional testing based on whether a problem in the nervous system is suspected, and in what part (brain spinal cord, which are best assessed by MRI, or peripheral nerves, which are best assessed by a test called EMG/NCS which tests how nerves conduct electricity and how muscles respond).
Fogginess in the brain is a vague symptom and I am not sure exactly what to make of this without being able to know further details. You mention you have a few episodes where you feel you are going to pass out; if you are experiencing light-headedness, causes could include low blood pressure such as due to dehydration or autonomic dysfunction, cardiac problems, and several other non-neurologic causes. Anemia can cause light-headedness as well. More often than not, light-headedness is not neurologic in cause. But one potential cause is a problem with the autonomic nervous system. The autonomic nervous system is the part of the nervous system that controls blood pressure, heart rate, and other functions. It is not located in one specific part of the brain or other body part but is rather made up of several different components: a region in the brainstem, certain receptors located on blood vessels and in the heart, and small nerves in our skin, among other areas. Dysfunction of the autonomic nervous system due to whatever cause can lead to a variety of symptoms including but not limited to orthostasis (which means symptoms or signs resulting from assuming an upright posture), light-headedness with drops in blood pressure when sitting up or standing up (this is an example of orthostasis), syncope (passing out), constipation, diarrhea, sweating abnormalities etc. If there is a problem in the small nerve fibers, what is medically termed a small fiber neuropathy, in addition to these symptoms, burning/tingling in the feet and hands or mild sensory loss may also occur.
Other potential causes of head symptoms such as fogginess associated with episodes of sweating and a sense of anxiety include panic disorder, certain endocrine (hormonal disorders), depression, and anxiety.
It sounds like you are on the right track with plans for evaluation by a neurologist, and if your symptoms are not felt to be of neurologic cause, re-evaluation by your internist, and possibly referral to a cardiologist, may be of benefit.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
It sounds like you have been having some unsteadiness, and a sensation of "fogginess". These, as described above, are nonspecific and could be due to a variety of causes.
In general, unsteadiness on the feet can result from many different causes, including a problem in the nerves in the arms and legs (what is termed a neuropathy), a problem with the spinal cord (what is termed a myelopathy), a problem with the part of the brain that coordinates our movements (called the cerebellum). Sometimes, no specific cause is identified, and all that is needed is some physical therapy and conditioning. Without more information, it is difficult to provide you with more information about your unsteadiness, but a thorough physical examination by the neurologist will help differentiate all these various causes, with possibly additional testing based on whether a problem in the nervous system is suspected, and in what part (brain spinal cord, which are best assessed by MRI, or peripheral nerves, which are best assessed by a test called EMG/NCS which tests how nerves conduct electricity and how muscles respond).
Fogginess in the brain is a vague symptom and I am not sure exactly what to make of this without being able to know further details. You mention you have a few episodes where you feel you are going to pass out; if you are experiencing light-headedness, causes could include low blood pressure such as due to dehydration or autonomic dysfunction, cardiac problems, and several other non-neurologic causes. Anemia can cause light-headedness as well. More often than not, light-headedness is not neurologic in cause. But one potential cause is a problem with the autonomic nervous system. The autonomic nervous system is the part of the nervous system that controls blood pressure, heart rate, and other functions. It is not located in one specific part of the brain or other body part but is rather made up of several different components: a region in the brainstem, certain receptors located on blood vessels and in the heart, and small nerves in our skin, among other areas. Dysfunction of the autonomic nervous system due to whatever cause can lead to a variety of symptoms including but not limited to orthostasis (which means symptoms or signs resulting from assuming an upright posture), light-headedness with drops in blood pressure when sitting up or standing up (this is an example of orthostasis), syncope (passing out), constipation, diarrhea, sweating abnormalities etc. If there is a problem in the small nerve fibers, what is medically termed a small fiber neuropathy, in addition to these symptoms, burning/tingling in the feet and hands or mild sensory loss may also occur.
Other potential causes of head symptoms such as fogginess associated with episodes of sweating and a sense of anxiety include panic disorder, certain endocrine (hormonal disorders), depression, and anxiety.
It sounds like you are on the right track with plans for evaluation by a neurologist, and if your symptoms are not felt to be of neurologic cause, re-evaluation by your internist, and possibly referral to a cardiologist, may be of benefit.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Post Comment
Anxiety can play tricks with our minds and metabolism. Maybe try some things that might be calming (until you get to see the neurologist which is wise) eg a bit of time away from the kids, some deep breathing exercises, yoga, walking and meditation if you can get into it.
If you are interested in my post (Neurology Members Forum - Am I going crazy or is my brain malfunctiong?) you will see my appointment is on 23rd Nov which seems too far away when I want to know now what is happening - which I pick up from you is the case. Keep me posted.
what trips me out is that ALL of us feel the same symptoms and yet no medical doctors can determine how to make us feel better. For me, I"m thinking it might be a nerve thing. I honestly do not know. And it must be a challenge for you because you have to take care of a family. For me just taking care of myself is a challenge already. I have been praying more everyday I wake up and go to sleep. I've been trying my best to stay positive and jump around like I used to. Whenever I tell friends or family, I know they feel for us and care but since they do not know how we "feel" its very hard for them to understand. What erks me is co-workers or people who have less sympathy because they automatically think we are crazy. I know we are not crazy. We know our bodies and understand how we feel and know if there is something is wrong. The only daunting challenge is trying to find a solution. I have been trying that netti-pot for my pressure on my face. It helped a little but I can't get rid of the dizziness and nervous spacey feeling. The only slight comfort I know is I am not alone and the stories I read are some what comforting but frustrating because we are in the same boat. I really hope the Nero figures out what is going on with you. Ask about any nerve testings. Its obvious our "brain" is our central nerve system that controls our bodies and emotions, etc. So there as to be a reason this is happening to us. I am trying to find a hobby or do something that will take my mind off of it. Its hard to do. I believe you will get through this and I will pray for you!!! Please know that there are people who care, even those who read your postings :)
Keep me posted ok. And I will let you know how I am. Please have a Blessed day and think positive!
i have mood swings anxiety and anxiousness, I get panicky and have panic attacks
For me it was all weird but whjen I found out what was causing it I felt reassured in a sense
A little scared about the future and fearful
But assured that finally I had some closure on my weird feelings
i also suffer from dizziness
Eye pain and migraine headaches
my vision gets blurred and it looks like I am seeing a series of a bout six light blue colored fans in front of my face when I go froma dark room to a lit room some of your symtoms seem similar to mine taht is why I felt encouraged by your story
good luck with everything and hang in their you need to find out whats going on and believe me it is good to get closure on why these weird things are happening
I hope this is not too klongsymptoms seem similar to what I have and my Neorologist has said I have a certain condition which i don't feel qualified to say in this post
But i am seeing a clinical psychologist also she is the one who suggested I follow through with the tests I and appointments I had arranged through my GP to see a Neuorologist
My Neurologist sent me to get a brain scan and brain monitoring and Brain and Spine MRI i also had a series of blood tests and visited a cardiologist who did a cardiograph and a dopler and I had a ultrasound on my heart
it all took ages
The final diagnosis was vague to me at first but since joining this site and others like it and doing some reading I feel hopeful and strangely positive And again I thank you for your braveness and sharing your experiences and signs and symptoms