Talk to Neuro Physician on Psychogenic Seizures
Asking for Sister, Female, 13 years old, Pakistan
My 13 yrs old sister has been experiencing difficulty in breathing and intense pain in heart that spreads to the whole left arm for 4-5 months.Jerking of the body was also noticed for few min when she is asleep. We took her to 3 different GPs, we were told that it's just cause of weakness and deficiencies so we started working on that.Still no betterment.One night we noticed some extreme body jerking /tremor , woke her up and she was having difficulty breathing. we rushed to the emergency,they said could be an epileptic seizure. Since it lasted for almost two hours, an injection was given to put her to sleep. Then we took her to a neurologist who diagnosed her with psychogenic seizures after EEG report. After 2 weeks he suggested to consult a psychiatrist because of no signs of betterment. The psychiatrist changed the medicines and after taking only 1 dose of it ,her condition became even worse. Hands and feet became stiff and still,getting scared cause of nightmares,being unconscious,
Dr. Ahmed Wali - Neurologist
FCPS (Neurology), Fellowship Neurophysiology (AKU), Diplomat American Board of Clinical Neurophysiology (DABCN), | Quetta
300 Positive Reviews
This is really a difficult case. The question is between true seizures and psychogenic seizures. In this case it is better to consult a child neurologist (peads neurologist) or child psychiatrist. Both can help if available in your town. Such cases are diagnosed after multiple consultations. Meanwhile her video EEG is the appropriate test to do. This test will clearly differentiate between psychiatric vs true epileptiform fits.
So first step is to visit child neurologist i guess. I dont know if her cardiac work up is carried out or not?
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Dr. Ahmed Wali - Neurologist
FCPS (Neurology), Fellowship Neurophysiology (AKU), Diplomat American Board of Clinical Neurophysiology (DABCN), | Quetta
300 Positive Reviews
As i said before, some times sevral inputs are needed for a problem to reach the diagnosis.In this case it needs at least 2 consultations. Child Neurologist and cardiologist.
2nd ,in my opinion, a single video EEG which is recorded at least for 2 or 3 days, may get you all the answers.
A good VEEG recording with simultaneous cardiac rhythm monitoring can tell you both neurological condition as well as cardiac involvemement. And if the spells occures at night it will differentiate between night terror and nocturnal seizures as well.
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Anonymous User
Thanks again for responding Sir. What are we supposed to do if the neurologist I am consulting does not order a VEEG..?
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Thanks for responding. No, her cardiac work hasn't been carried out. We have never been referred to a cardiologist. Rather one doctor suggested that it could be the case of orthopedics. After that the fits became our main concern because of their severity and it seemed like that both the problems were somehow connected.But she still complains of severe heart pain that spreads to the arm. Also Only EEG was done that came out normal and the neurologist diagnosed it to be psychogenic and referred us to a psychiatrist. She was given an antidepressant and her symptoms became worse and frequent. Since she has a lot of difficulty breathing during fits/seizures , it diverts my mind towards panic/anxiety attacks? Since the neurologist described anxiety to be the main cause behind it.She gets scared of nightmares she sees every time she sleeps and wakes up all panicked and anxious is the reason I wanted a psychiatrist to treat her. Or could it be an organic non-epileptic seizures ? Now should we again consult a neurologist or another psychiatrist or a cardiologist? We want all of these issues to be resolved whether they are connected or not.
1 month ago