is this epilepsy?

[sunzzofman]

I'v had really bad dizziness for just over a year now,first docs said it was a ear infection,then stress,then i got a 24 hour ecg that came back fine and now they say its stress again but iv been refered to a neurologist!(finaly).basicly the dizziness i get is a big eleectric like rush that shoots thru my brain,its completely random sometimes i could be laying in bed chilling watching some tv or playing a game and it just happens,after i feel really ill for the next few days,does this sound like epilepsy?

symptoms:
randomly feel i need to pass out and my ears start ringing but my body wont let me pass out
headaches
dizziness all the time,but now and then a big head rush thats like eletric shooting through my head
left side of body twitches (neck,left arm and left leg)
if i sleep less hen 10 hours i allways feel like i want to pass out
allways feeling weak and legs are like jelly
computers and tv make me worse somehow
vision seems weird yet my eye test was fine,sometimes when i had a funny turn i get double vision for a few seconds
get pins and needles in my feet quite alot
randomly start feeling ill and dizzi and my pupils go massive

tests iv had done is ear hearing test with a ent spec said ears are fine
bloods for iron,allso checked for diabeties
ecg and a 24 hour holter moniter which was fine

the main probley is this random huge rush i get shooting thru my brain,its like electric going frm the bottem of my brain to the top

[Christopher R Newey, DO]

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.

Pins and needles sensation is often associated with a condition called neuropathy, but other conditions are in the differential. There are 2 types of nerves that provide sensation to the feet and hands, large nerves and small nerves. A problem with either of these could lead to tingling. There are many causes for this. They include but are not limited to most commonly diabetes, vitamin deficiencies, autoimmune disorders such as lupus or a disease called Sjogren's, certain types of neoplasm, and certain toxins (such as lead). Also, there are several other genetic, metabolic, and hereditary disorders that cause neuropathy, and what tests need to be ordered depend on the history and physical examination. With small fiber neuropathy, the EMG/NCS test which measures how nerves conduct electricity and how muscles respond to them may be normal. In large fiber neuropathy, it will be abnormal. Small fiber neuropathy can be diagnosed with a skin biopsy and with a test called a QSART.  A common medication used for neuropathy is gabapentin or pregabalin.  

Additionally, symptoms present on one side of the body versus the other, or in just one limb could include a stroke or the condition multiple sclerosis. These would best be excluded by an MRI.

If symptoms migrate (move from one place to the other) and are intermittent, causes might include seizures, migraine disorder or metabolic problems such as low calcium.

Often these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.

I am not sure what you mean by the term dizziness. When some people use the term dizziness, they often mean vertigo, or room-spinning. Others mean a light-headed, whoozy feeling.

If by dizziness you mean vertigo (room-spinning), the causes could be either the inner ear or the brain. Inner ear causes of vertigo most commonly include benign positional vertigo (BPPV), which is due to small particle in the inner ear that moves out of place, and can be repositioned with simple head maneuvers. The symptoms often include vertigo that occurs with turning of the head, often while turning over in bed. Another cause, if your symptoms are associated with tinnitus (ear ringing) and hearing loss is called Meniere’s disease and can be treated with medications and sometimes surgery. And so on, several other causes from inner ear problems exist.

Vertigo can also be due to problems in the brain. The most common is a benign tumor called a schwanoma (also called acoustic neuroma). This is diagnosed by MRI of the brain. Multiple sclerosis can cause vertigo, but often, other symptoms are present as well. A normal MRI of the brain excludes multiple sclerosis. Thyroid problems can also lead to vertigo.

Your symptoms may be a variant of migraine. Basically this is marked by several hours of vertigo associated with nausea, light-sensitivity, and sometimes other symptoms. Headache may or may not be present. The treatment is different from that used to treat other migraine types; the treatment in this case is a type of medication called calcium channel blocker, such as verapamil, which is actually used to treat blood pressure but works in type of basilar migraine as well.

If by dizziness you mean 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.

It is good that you have had an evaluation by an ENT. Continue following-up with your doctor is recommended. A neurological evaluation may be beneficial.

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

[sunzzofman]

so say for example i came to see you with these symptoms what would you do? would you do a certain test first or sumin