presyncope

[lydia231]

I have been having symptoms which resemble presyncope.  I was wondering if this could be ms related.  I have read some reports which state it could only be caused by cardiovascular problems, but have read other reports that state it could be neurological. I see my neurologist on Thursday and would like to discuss this with her. I would like to have a little more information beforehand. If it could only be caused by a cardiovascular disorder I will probably speak to my gp instead.

I have been having dizziness, but at times feel like I have blacked out. It only lasts a second and have never completly lost consciousness or fallen down. Sometimes these symptoms are so strange I even doubt myself, no wonder the doctors question their validity.

[whaaaa]

Hi, It sure sounds alot like what I'm experiencing. It's nerve racking. The cardiologist that I saw ruled out cardio problems with just an EKG. He did say that it could possibly be petit mal seizures but, In my head I'm thinking 20 to 30 of these episodes a day, when I 've never had seizures before? There must be something else going on. Hope you find out what the problem is and feel better!

[jensequitur]

Lydia, I'm not sure if your initial question has been answered - should you go to your neurologist or your regular doctor.  Do you have a neurological condition right now?

Definitely talk to the neurologist about this problem.  As Bob says it could be seizure activity.  Your description of how you feel before and after makes me think it's neurological.

At any rate, I think that going to your neurologist is a good idea, as you're going to see him Thursday anyway.  But unless there's good reason to believe it's neurological, you're probably going to have to see your regular doctor as well to rule out fainting spells.

[drsdonthelp]

I have had an episode of tunnel vision, kinda like when everything around the central part of vision is blacking out but then returns and then goes again. This happened while watching a movie and the lights were flickering on the tv. Its a good thing I was sitting down, I probably would've been on the floor. I asked my neuro if this could have been considered my simple partial seizure, and he did document it as one.

[summerluvr]

there is another thread about fainting.. check it out some good descriptions.

I started fainting which ultimately led to my non-ms diagnosis, but I have the type of black out where you get tunnel vision, everything sounds far away, then bam next you hear is your head hitting the floor. It first started happening when my blood levels were way off (severely anemic, very low hemoglobin) and I had a lot of dizzyness and weakness too.  Now I get the feeling I'm going to black out, but I know to sit down, drink something eat something, and bring my blood pressure up.

[sllowe]

Yes, and that (among other testing) should absolutely be general rule as part of the electrophysiologists testing as well.

[COBOB]

Shell, that being said, increased vagal tone (Cranial Nerve 10) typically causes a decreased heart rate.  That is the reason so many people are put on Holter monitors (24 hour ambulatory EKG) for testing.  In the US, most cardiologists do this testing as an outpatient procedure.

Bob

[sllowe]

Sorry I should clarify....I meant blood travels faster if you lay, so by doing so, it's a technique you can use to keep from passing out....

-shell

[sllowe]

Hi Lydia,

I don't think we met, so hello to you and nice to meet you. Did any doc mention presyncope to you? What you describe can very well be a number of things, but my recommendation is to get to your MD for a thorough work-up and physical and then ask your MD how he/she feels about sending you to an electrophysiologist. These docs are fab and can rule in, or out cardio problems. They are cardiologists who specialize in physiology and pacing.  

It's good you can feel it coming on. Best thing to do is to lay when you feel it coming on. Blood travels quicker through your heart and to your brain, and if you are experiencing some sort of neurocardiogenetic (or sometimes referred to as vasovagal)syncope this is an absolute must so you don't get hurt badly from a fall. Your MD should know this and also that all your tests can come back completely normal, including CTs, EKGs, Echo's, etc. and you can still have this condition.

-Shell

[COBOB]

It can be cardiovascular or neurologic.  Your doctor will need to rule a few thing out.  Several of the folks on the forum have had to go through Holter (24 hour EKG) monitoring to make sure the issue is not cardiac.  The problem here is that this could be a drop in heart rate or it could be a petit mal seizure.  There are a few different seizure activities associated with MS and they are not uncommon.  

The problem with petit mal (or absence seizures) is that the patient is unaware and after the seizure (postictal) you can get that "I don't feel right and need to sit down" feeling.  This is one of those thing I'd say you should talk to your Neuro about.

There are also "MS Drop attacks" where some PwMS loose muscle tone and feel weak for a short period.  They feel like they are going to "hit the floor.":  The only way for a doctor to tell if it is a seizure is an EEG.

A good description can be found at http://nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/seizures/index.aspx

If you have never had cardiac issues,  I'd almost bet it is low grade seizure activity that is common with MS.  

Bob

[lydia231]

It is hard to discribe, but when I have this happen it is like I loose consciousness for just a second than become aware again. I will feel dizzy and extremly fatigued when this happens. I don't think I should have used the word "black out', but am having trouble describing what happens. I am having some extreme cognitive issues lately and finding the correct words to discribe things is very difficult if not outright embarrasing at times.

[supermum_ms]

Hi lydia,

I'm not sure I understand, if you describe the sx you are thinking might be presyncope, it might help us to understand better. Also what do you mean by 'black out' if you black out you should drop or start to drop, could you be having a spin out from the dizziness, a temperary feeling but can leave you feeling very unsettled?

Cheers.......JJ