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Behavioral or a CNS Disorder??
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Behavioral or a CNS Disorder??

I m 15, live in India. 1 year earlier, my eyesight got blurred & this blurring increased to short bouts of complete blackouts(10-30 seconds, 3-4 times/day) i also used to hve severe headache. Pathalogical tests were done, everything was normal. We consulted ophthalmologist & he said eyes/eyesight were 100% fine, he referred me to neurologist I underwent EEG, MRI & CT - everything was normal. 1 day mild shivering in my h&s started & stayed on for 2 hrs & neurologist indicated it could be deficiency of VitaminB1 & migraine

After 1 week, on one day shivering got intense & it transformed into jerky movement (in both arms) & same day the jerky movement became intense tht they reached my abdomen & with each jerk abdomen was rising 4-5 inches frm bed with each jerk (worst ever i had these jerks). i was admitted to neurology ward, alongwith neurologists & psychiatrists were consulted. They (the latter) diagnosed it as Dissociative Disorder (as per neurologists & psychiatrists all symptoms were imaginary as the medical / diagnostic tests indicated no abnormality) & mentioned tht problem is stress based so it needs no medication

The psychiatrists & neurologists were 100% sure tht it is all stress induced & behavioral therapy would gradually help me out of this all. All the symptoms & jerky movements faded away after 1 month. it is 1 year & i hve been regularly visiting the doctor for counseling & behavioral therapy. Jerky movements hvent stopped. i keep getting them often (once/twice in 2-3 days) & now additionally at times i suddenly fall asleep & my parents say I speak during this sleep(at time I say, "pl. dont leave me alone" "I wont tell anyone" "I dont want to go alone" etc) & invariably tears start rolling frm my eyes. When i get up as if i was sleeping normally. at times I forget some events/period those took place before jerks. Doctors r maintaining I will be fine with the counseling. I hve not been prescribed any medication. Please help me with the diagnosis?
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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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
It is reassuring that you have had a fairly complete workup for your condition. The initial symptoms you describe (i.e., the blurriness of vision and headache) is likely a migraine with aura. The headache will usually occur within 30-60minutes after the visual symptoms, but the headache does not always have to follow. As you are probably aware, migraines are typically a unilateral, throbbing head pain that is severe that may be associated with nausea, vomiting, light/sound sensitivity, and can be worsened with activity.

The other condition that you mention is a nonepileptic seizure. These events are paroxysmal. What really determines them from epileptic seizures is that these types will not have EEG changes when the event occurs. Have you had an EEG during an episode?  Additionally, studies have shown that up to 40% of these patients may also have true seizures. This is what makes this diagnosis so difficult. These seizures are more common in young females. They should not occur during sleep. Since you are having sleep disturbance, it may be worthwhile to discuss with your physician a formal sleep evaluation.  Has your physician actually seen an event? If not, it may be worthwhile to record an event and show him/her.

The treatment of nonepileptic seizures does not include medication. The mainstay of treatment is psychological therapy.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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