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Dizziness and seizure disorder

Posted by Sylvia Shirley on May 03, 1999 at 10:19:17
I would appreciate any advice you can give me.  I am a 43 year old woman, generally in good health.
Over a year ago, I started having some dizzy spells, and occasionally fell down.  It became enough of a problem, that I went to see my primary-care physician.  He did a couple of blood tests, which were negative, so he prescribed anti-depressants.  I did not have a problem with depression, and felt like he blew me off, so I did not get that prescription filled. I just hoped it would go away.  Over the next several months, the dizziness got much worse.  I went back, he ran more tests, I went to other doctors, and had other tests, and none of them showed anything.  Finally, last Friday, my new primary-care doctor (an Internal Medicine specialist) got the results of an EEG, which she said showed some kind of seizure activity in the left temporal lobe.  She called in a prescription for Valproic Acid. I have taken six doses so far (250 mg each).  This medicine makes me miserable with heartburn, no matter if I take it with food or not, and I have not seen any relief from the original problem.  In fact, it may actually be a little worse.  It's another two weeks before my next appointment with her.
These occasional waves of dizziness have progressed to the point that now I am dizzy virtually all the time.  In addition, I have a weird "numbness" in the front of my head, above my eyes, and I feel sick at my stomach all the time.  I was falling a lot, and occasionally lost consciousness, but now, I move around so little, there's less chance of falling.  I have had to give up my job, driving, exercising, housework and everything else.  I feel like a total prisoner, and am very frustrated.  It seems like these doctors are really dragging their feet.  They will run one test, and tell me to come back in two weeks, then they run another test, and tell me to come back in three weeks, etc.  It's like they're hoping it will go away on its own by then.  Meanwhile, I've lost a year of my life.
My question is:  what else can I do?  I have asked for a referral to a neurologist, but both doctors have said they want to try a few other things first.  Is that an unreasonable request?  If there really is a seizure disorder, would an internal medicine doctor be the best one to treat it?  I really don't feel like it's a seizure, because it is going on ALL the time, in varying degrees.  When the worst dizzy spells come on, and it feels like I might pass out, I close my eyes, prop my head up on my hand, and wait till it goes away, usually 15-30 seconds.  Sometimes longer.  When I have lost consciousness, I did not have any twitching or muscle spasms.  My husband said it's like I just go to sleep for 15 seconds or so.    
There are other things going on, which I just chalk up to getting old, but just in case they mean anything:
Prior to the dizziness, I used to get headaches a LOT.  Horrible, blinding, sick at my stomach headaches.  In the last year I have not had any headaches.  Not even a little one. (Is absence of headaches a symptom?)
My knees buckle sometimes.
My right hand trembles slightly, most noticeably when I'm eating soup.
My right leg jerks sometimes when I'm trying to sleep, and wakes me up.
My right forearm feels sore all the time.
I have two left feet, and stumble a lot. Sometimes I must look drunk.
I don't sleep very well.
I have trouble concentrating, and can't seem to focus my mind on anything. I've stopped reading.
I forget words.  For that matter, I forget lots of things.
My vision seems blurry all the time, even though the eye doctor can't find anything wrong.
Five months ago I was diagnosis with asthma at the emergency room, which is probably not related to the dizziness.  I have an emergency inhaler, but have needed it in over two months, so I'm not currently taking any medication for it.
I would appreciate any advice you can give me.
Thank you.
Sylvia Shirley
Posted by Sylvia Shirley on May 03, 1999 at 10:29:40
I forgot to mention that I also have pressure in my ears all the time.  It feels like when you're in an airplane and need to yawn or swallow to pop your ears, except mine won't pop.  Also, I have occasional pain in my ears, where it feels like they're out of joint. It hurts a lot, but I can make it go away by rubbing the bone behind the ear.  It seems to be related to pressure.
That last sentence of my previous post, about the asthma medication should say "I have NOT needed it in over two months".  I left out a word.  Sorry.
Thanks again.
Posted by Elaine P. on May 03, 1999 at 12:56:01
I too am looking for advice.
I hesitated in responding but my daughter is suffering from similar symptoms.  She is 16 and was diagnosed with Left Temperol Lobe Partial Complex Seizure Disorder when she was four.  She has not had any seizures in many years but she too has been experiencing dizzy spells.  It hits her frequently throughout the day mostly when she is walking.  She gets a  "tingling" around her mouth and a flash of tingling down her right side of her body to her toes that she says feels like a wave going over her body.   Sometimes she has to hang on to keep from falling down.  Her recent EEG was normal and she sees her neurologist on Wednesday.  She says it is sometimes worse after she eats.
Could this be related to her Seizure Disorder?  Perhaps a middle ear infection?  Hypoglycemia?  
Sylvia, I hope it was ok to add on to your post.  My daughter's symptons are not as severe as yours.  I know how frustrating things can be.  I wish you the best of luck.  :-)
Sincerely,  Elaine P.

Posted by CCF MD mdf on May 04, 1999 at 13:25:51
This sounds much too complicated to be the product of a single disorder. I suppose it is conceivable that you have some sort of epilepsy, but I would want to know more about the EEG and the specific symptoms and their timing.
Many of the symptoms do not go with seizures. That doesn't mean you couldn't have seizures, it just means that there's more than one problem going on.
Dizziness, soreness, trouble concentrating, sleep disturbance, and some of the other symptoms often add up to depression or anxiety states. Making that diagnosis is easy when a patient comes up and says, "doc, I'm feeling a little depressed" or "I have a lot on my mind." But these symptoms can come out of the blue and not necessarily be associated with feelings readily identifiable as depression. It's worth taking seriously and worth treating - the right approach to treatment can make a lot of difference in symptoms.
You should see a neurologist for several reasons:
(1) clarify whether you have seizures
(2) suggest appropriate medications for seizures if that's needed - for example, if the problem is localized to the left temporal lobe you may have more medication options than you know. Valproate is a good medicine, but if you can't tolerate it there are others.
(3) examine your tremor to determine its significance.
(4) sort out some of the other symptoms, if possible.
We are available if you wish at CCF. You may call 800 223-2273 and ask for neurology appointments at 4-5559. I hope this helps. CCF MD mdf.
Posted by Sylvia Shirley on May 04, 1999 at 16:43:48
Dear Doctor,
Thank you for taking the time to offer your advice.  I really do appreciate your comments.  It's kind of funny, that when I tell a doctor I'm dizzy, they say it's not enough to go on.  When I tell them every ache and pain,  hoping they'll find something useful, they think I'm nuts.  I guess I'm not very good at expresing myself clearly.
Things have actually been very peaceful and stress-free in my life lately, and depression has not been a problem. Except for this dizziness, of course.  It's causing some anxiety, that's for sure.  
Thanks again for your input.  My doctor is now trying to arrange an appointment with a neurologist.  

Posted by V.Perri on May 24, 1999 at 19:47:37
I,too, have had strange and similar symptoms, especially the dizziness. I suffered dizziness everytime I laid down to sleep or shifted my head upwards for about 4-5 months then it suddenly disappeared. For about 2-3 months I was okay but then suffered a grand mal seizure. For a few years I have suffered, and still do, with migraine headaches located only on the left side of my head. I never had these treated by a doctor, I usually just would take Tylenol and try to lie down and go to bed early. After my seizure, I started going to a neurologist and had many test ,MRI's, CT, regular EEG, then after seeing my neurologist for about six months, I had a sleep-deprived EEG. It showed an abnormality in my left temporal lobe. I currently take Dilantin and she has prescribed Esgic-Plus for my headaches. During this time I was also under a lot of stress. Now, almost two years later, I have not suffered anymore seizures,
(just had that one) but I still get the headaches and I do try to keep things less stressful for myself. The doctor had said that migraines can sometimes affect you in a way where you can suffer a seizure, I was told I'll always have this condition in my temporal lobe, my last sleep-deprived EEG was the same as the first one. I also have TMJ on the left side (Temporal mandibular joint dysfunction), I'm not sure it's related but it's very painful at times, especially with a headache.
Happy to share my information, I'm a 42-year old female, good luck in your search, I feel the same way.

Posted by CCF Neuro[P] MD, RPS on May 25, 1999 at 16:07:18
Dear Valerie:
thanks for sharing.
CCF Neuro MD

Posted by V. Perri on May 25, 1999 at 19:22:58
I have a question in regards to seizures; can migraine headaches alter the condition of the brain to make you prone to a seizure if the headaches are not treated, as I mentioned before, I never saw a doctor for my headaches until after I suffered a seizure. I appreciate your comments.
Thank you.

Posted by CCF Neuro[P] MD, RPS on May 26, 1999 at 19:33:43
Dear Valerie:
Usually it is the other way around.  Post seizure, a migraine headache can occur.  This is the usual case.  Migraine and epilepsy are distinct entities.  Both can co-exist in the same individual.  Migraines do not usually precipitate seizures, although it has been reported (it is rare).  Usually, although it is not known if it occurs universally, the migraine is an aura to the epileptic seizure.  This is usually a temporal lobe seizure.  Most think that the migraine in and of itself does not make the brain more sensitive to seizures.  But as I said, there are people in whom both co-exist and thus there is a chance that migraine can predispose one to a migraine. The answer is "sort-of" and maybe.
I hope that helps and doesn't confuse the issue.
CCF Neuro[P] MD  

Posted by V.Perri on June 01, 1999 at 21:55:37
Dear CCF Neuro (P)M.D.,
Thanks for the information, I appreciate it. I hope to hear from others who have experienced these same symptoms and conditions.
Valerie Perri

Posted by CCF Neuro[P] MD, RPS on June 02, 1999 at 20:21:53
Dear Valerie:
You are welcome.
CCF Neuro MD

Posted by Rodney Ball on June 06, 1999 at 21:57:54
Your symptoms sound very familiar. About a year ago I started
having dizzy spells about every two weeks.  After five or six
different tests I was finally asked to take a Head Up Tilt Table Test and was diagnosed with Neurocardiogenic Syncope. My spells were worse when I walked for long periods, was in the hot sun, in stressful situations, would stand in one spot for long periods of time, and often times while I was eating.  I don't know if this is exactely what you are going through but I know it's a tough thing to deal with and it is having a very negative effect on my life as well.  Regarding the anti-depressants, zoloft (an anti-depressant} was prescribed and made a world of difference.  Apparently this dissorder effects the communication between the brain and the heart and how your body keeps a steady or appropriate blood pressure level.  Anyway, you might ask your doctor about taking a Head up tilt table test.  Hope things get better!  
Posted by CCF Neuro[P] MD, RPS on June 07, 1999 at 20:44:17
Dear Mr. Ball:
CCF Neuro

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