Termors, walking problems

I am still experiencing mild tremors, a feeling of instability when I walk, and an increase in back pain in the lower lumbar and mid thorasic regions of my spine. I say still because a year ago I experienced a stressful plane flight during which most of us passengers felt we weren't going to land. Shortly after that I went through a period of severe convulsing and seizure like behavior on a daily basis for about 4 months. Things have subsided for the most part but periodically reappear, and much to my chagrin I have found that I can initiate some of the behaviors. I can do this visually by staring at one thing close up, stretching my arm(s) outward for a period of time, touching my hands together finger tip to finger tip and looking at them, and by standing upright, arms out front with palms turned up. With the finger tip situation I do not have a response if my eyes are closed. The back pain issue has been with me for quite some time but has been gradually worsening through the years. I'm wondering if there might be a connection somehow? Specifically, I can barely walk on my toes and maintain balance. I can walk on my heels.

I have had MRI's, CT's, Trans-Crannial Doppler's, been tested for a number of genetic causes, MS, and epilepsy. Nothing remarkable has come out it all. I've been told it's all psychosomatic / psychogenic yet the shrinks aren't coming up with anything. The one I'm seeing now has said, to paraphrase him, "If all your physical symptoms are the result of a psychological problem, it's the most bizarre and unbelievable thing I've ever seen." He specializes in Cognitive Behavior Therapy. I've been on meds too and still experienced problems.

[CCF Neuro[P] MD, RPS]

Dear Misc Problems:

The good news is that all of your tests have been normal.  There is an entity called pseudo seizures.  These are seizure-like events that are not caused by abnormal brain waves (I am assuming that multiple EEGs have been normal).  They are due to the psychological state and can be from a conversion disorder.  This condition is very well known. Is your muscle weakness demonstrated on neurological exam by a neurologist?  Or is the weakness not present on exam but you still cannot toe walk.  If the latter is the case, together with the pseudo seizures and the stressful plane ride may indicate a conversion disorder due to post-traumatic stress.  I am not an expert in this area and will leave this to the psychological folks.  

CCF Neuro MD

[Misc problems]

Dear Doc:

Thanks for the reply...I have been told by the reviewing physicians/neurologists that I have strength. From my perspective it varies tremendously at times and wonder why I have not heard statements of a more precise nature;i.e.,you have control and ability to resist but the strength is less than I would expect. Or, it seems strange that your strength this direction is noticeably stronger than the other direction. Perhaps my legs need to be paralyzed before I'll hear a statement confirming I have problems. Sarcasm aside, my 2 EEG's were normal. My problems with toe walking occured at an exam after the physician said I exhibited no "strength problems". It was strange experience of not feeling control over my balance and sensing I was not able to instruct my legs where to move. I was able to heel walk basically fine. My history has me freezing to the floor on a few occasions, and developing pronounced leg tremors and walking difficulties after standing and urinating.
BP problems? I am already talking to a psychologist and he thinks if my non-epileptic seizures are a result of a psychological condition, that condition will be the most bizarre one he's ever seen. He basically thinks it's neurologic. The neurologists think it's psychological. And I'm stuck in the middle!!! Can brain chemistry fluctuate to such an extent that non-epileptic seizures occur on the slightest "insult" to their balance, whether dietary / hormonal / chemical etc...?

Hope you'll respond to this too...thanks

[Cher]

Please go to Carbon Monoxide Headquarters on the internet.  Pay special attention to the Chronic sections (lower than lethal levels, but still very physically damaging)  PLEASE, CHECK IT OUT!

[CCF Neuro[P] MD, RPS]

Dear Misc Problems:

Yes, brain chemistry can fluctuate, however, likely not to the extent that you would show the symptoms you describe in such a acute fashion.  If your muscle weakness was due to a brain abnormality, then it should have been detected on physical exam as weakness is usually not episodic with the symptoms as you describe.  There is always the chance that you might have a periodic weakness that is related to ion channel dysfunction.  Talk to your neurologist about these conditions.

CCF Neuro MD

[DAVID STACKHOUSE]

I HAVE HAD  AN EEG CAME UP NORMAL AS WELL AS MRI'S THEY ARE TREATING ME FOR MS I WENT TO THE HOSPITAL AND THEY SAID THAT I WAS HAVING PSEUDDO SEIZURES THIS IS NOT IN MY HEAD MY BODY STIFFENS UP LIKE A STONE I GET THIS BAD CRAMPING FEELILING THAT TRAVEL ALL OVER MY BODY AND SOMETIMES IT IS LIKE SEIZURE LIKE SYMTOMS (symptoms) I LOSE MY BLADDER WHEN I GET REALLY BAD ATTACKS WENT TO A SPEACLIST AND THEY SAID MY BLADDER WAS FINE I AM BESIDE MYSELF  I CANNOT DRIVE DUE TO UNEXPECTED ATTACKS AND BLURRED VISION I AM ON NEURONTIN PREDISONE TEGRETOL NORVASC PERCOCET FOR PAIN MEMORY LOSS AT TIMES BUT CONCENTRATION IS THE MAIN THING I DO NOT HAVE A MENTAL PROMBLEM I ALSO FOAM AT MY MOUTH WHEN I GO IN TO AN ATTACK I ALSO GET RELLIEF FROM A COLD RAG ON  MY HEAD I COULD  GO ON ETC. PLEASE HELP!!!!!!!!!!

[DAVID STACKHOUSE]

I HAVE HAD  AN EEG CAME UP NORMAL AS WELL
AS MRI'S THEY ARE TREATING ME FOR MS I
WENT TO THE HOSPITAL AND THEY SAID THAT I
WAS HAVING PSEUDDO SEIZURES THIS IS NOT
IN MY HEAD MY BODY STIFFENS UP LIKE A
STONE I GET THIS BAD CRAMPING FEELILING
THAT TRAVEL ALL OVER MY BODY AND
SOMETIMES IT IS LIKE SEIZURE LIKE SYMTOMS (symptoms)
I LOSE MY BLADDER WHEN I GET REALLY BAD
ATTACKS WENT TO A SPEACLIST AND THEY SAID
MY BLADDER WAS FINE I AM BESIDE MYSELF  I
CANNOT DRIVE DUE TO UNEXPECTED ATTACKS
AND BLURRED VISION I AM ON NEURONTIN
PREDISONE TEGRETOL NORVASC PERCOCET FOR
PAIN MEMORY LOSS AT TIMES BUT
CONCENTRATION IS THE MAIN THING I DO NOT
HAVE A MENTAL PROMBLEM I ALSO FOAM AT MY
MOUTH WHEN I GO IN TO AN ATTACK I ALSO
GET RELLIEF FROM A COLD RAG ON  MY HEAD I
COULD  GO ON ETC. PLEASE HELP!!!!!!!!!!

[DAVID STACKHOUSE]

PLEASE ANSWER

[Misc problems]

Cher:

I checked out the CO-HQ. Interesting. Recognized a bunch of the symptoms, having been there so to speak. However, all the possible sources of CO listed do not occur in my immediate environment. I live in an all electric house. I telecommute for the most part, and unknown to you, obviously, is how long and varied my symptoms have been. I simply chose not to go in to a lengthy description of what has been happening to me in the last few years of my life when I put up my post. The on-again off-again difficulty with walking is just one of my problems. The last time I posted a "list" of problems I got no where with responses. I figured I'd try a limited exposure, so to speak. I'll add another one now. Hey, maybe I should start a game of "Medical Clue". Each week I can describe a symptom I've had and folks can make their best diagnostic guess. Could be fun. Anyway, sometimes after I get up in the a.m. and I'm sitting having my morning java, my left arm will start behaving as if I have cerebral palsy or something. It slowly and jerkily waves around in the air, bending at the elbow, and my hand clenches in to a claw grip with my fingers spastically moving. Sometimes my hand will just lock up. If I try to reach for something with this arm, the waving becomes more pronounced, and I can't even begin to get my hand aywhere near what I want. Ok, that's two symptoms. No more hints till I hear some guesses. We all have to keep things on the light-side, yes? On the serious side, I'm not BS'ing anybody here. I have been through a lot scary stuff and the docs haven't come up with anything definitive yet.

[CCF Neuro[P] MD, RPS]

Dear David Stackhouse:

Pseudo-seizures are a real entity.  They are responses to stress or other psychological problems that induce a neurological behavior.  There is never an EEG correlation with movements.  A person will have an event and sometimes he/she will not be able control the behavior.  There are times when the individual can control the behavior.  Adults with pseudo seizures have a very difficult time overcoming their seizure-like events, most never are able to control them.

CCF Neuro MD

[barbara to David Stackhouse]

David,

Yes, I had a similar experence where the only Neurologist (Chinese) on Guam tried to tell me I was having pseudo-seizures!

My seizures are partial tonic-clonic where all my muscles stiffen up and I shake violently for 10 minutes or so. I usually have 2-3 in a row so I go nearly 30 minutes. It causes severe pain and weakness and disorientation. Since I was semi-conscious during these attacks the Neuorologist said since I was not un-conscious so it is pseudo-seizures.

It was caused from severe alcohol withdrawal, days 4-7 and (REACTIVE) -PARTIAL STATUS EPILEPTICUS as far as I am concerned! Not real epilepsy, only temporarily reactive to the alcohol withdrawal and DT'S!!!!!!!! I had over 60 seizures in less than three months while trying to quit the alcohol as an out-patient basis. It sucked.

Now I am seeing a psychiatrist who put me on Klonopin to control the withdrawal and seizures and help reduce anxiety so I can permamently stop drinking. The only time in my life I have had seizures is during alcohol withdrawal, so psuedo-seizures in my case is a bunch of balogna!

An EEG often does not show seizure activity especially if it is deeper in the brain or you are past the withdrawal phase!

They said I should have gone through video EEG monitoring but they don't have that on Guam. I have since relapsed on the damn booze so now I have to start the withdrawal from ground zero. I am really angry tonight not that anyone really cares! I just needed to get this off my chest. Sorry for the long babbling! I am 24 hours sober so at least it's not drunken babbling!

.

[Adrienne]

Hi David!!! I just want to comment that I can identify with you on certain symptoms & reponses you've gotten. Such as I've  been experiencing alot of scary symptoms also: tremors, muscle weakness,difficulty walking,feeling clumsy due to the tremors& weakness, some memory& intellect loss(FACTS,VOCABULARY& INFORMATION I KNOW IUSED TO KNOW),trouble sleeping-because of tremores,twitching,&shallowing breathing which wakes me up every hour. There is much more but i don't wnt to keep going on,I feel like all I'm doing is complaining and not one doc has been able to give me an answer. I know docs are human and not miracle workers, but it gets frustrating when you experience lots of strange stuff going on with you body. You know you're not BS'ing and one doc says "oh, its phycological" (& you know it's not) and others say "it's neurological". Well, thanks for clearing that up for me, I guess I'll just go home now and go through all of this day after day with no relief in sight. You knou you not crazy or do not have any serious mental illness, but you feel as though you're going crazy having to deal with all this strange stuff.Sorry to go on with this ...  I hope we get some answers soon. Good luck!! Comment if you can!!  Sincerely, Adrienne

[Misc problems]

Back again...As we all agree, this seizure stuff really sucks, as well as the varied responses we get from physicians. To us it really doesn't matter what causes them, we just want them to stop. I was dx'd with pseudo-seizures. However, two somewhat recent events have triggered uncontrollable muscle spasms in me. First I have a bad back and the other day it "went out on me". I didn't know it happened until I tried to stand up. Thinking a little warm water message from a shower would be beneficial I stood so the spray would hit my short spot, around L4-L5. Within moments my legs started trembling violently, my upper body shortlt followed, and it took all my effort to move my legs to get out from under the spray. I had trouble walking the rest of the day. Makes me wonder if my pseudo-seizures are somehow related. The second event, which I hope a CCF Neuro will respond to, is that I have noticed my eyes do not like to stay focused on anything for very long. They constantly shift back and forth horizontally. I decided to force them to start at a word on a piece of paper. Within 10 seconds or so, they were vibrating rapidly, a buzz began in my head, my right arm started to tremor, my neck muscles tightened up pulling my head down and to the right, my eyelids were forced closed, fascial muscles spasmed, breathing was forced, and I couldn't talk. I was conscious and aware of everything and could hear my bio-feedback R.N. telling me futily to control my breathing. This lasted approximately 10 minutes. Once the buzz stopped in my head I was back to normal within a minute. Now, is this pseudo-seizure or some kind of ocullarly stimulated idiopathic dystonia/dyskinea?

[CCF Neuro[P] MD, RPS]

Dear Misc Problems:

I can't tell.  Your event does not sound seizure-like.  Having both eyelids forced closed, ocular nystagmus in both eyes, only one arm involved, head version without ocular version, is not descriptive of a central induced event.  Dystonias are not triggered but are usually involuntary.  They are repetitive over time, so if the same event happens over time then it might be a dystonia. The description of a dystonic event is usually patterned and described by chorea, athetosis, etc which your description does not match.  The nurse would have likely described it to you as such.  Sorry, but it is difficult to tell you what it was without seeing the event.

CCF Neuro MD