[120F] With sudden onset convulsions and tremors

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Patient Description

A 120-year-old female experienced sudden onset of convulsions, tremors, teeth chattering, and muscle twitching today. The episodes began after a fall and being scared, with no other specific triggers. The patient remained conscious but experienced confusion, disorientation, weakness, and numbness in limbs afterward, along with headaches and visual changes. She has a history of chronic pain, anxiety, and depression, diagnosed in 2021 and 2023. Current medications include 15ml of Prozac and one daily pill of Slynd birth control, along with ibuprofen and Tylenol as needed. There are no recent changes in medication, no family history of neurological disorders, and no recent infections except for a sinus infection. Talking to a friend helped calm her during the episodes. No known drug allergies.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Seizure Activity: The convulsions, twitching, and teeth chattering could indicate seizure activity. Seizures can occur for various reasons, including stress, infections, or other underlying conditions. It's important to get evaluated by a healthcare professional to determine the cause.

  2. Panic Attack: The initial fear and subsequent physical symptoms might suggest a severe panic attack. These can cause shaking, teeth chattering, and a sense of losing control.

  3. Neurological Event: Given the numbness, weakness, and confusion, a neurological event such as a transient ischemic attack (TIA) or other neurological disorder could be a possibility.

  4. Reaction to Stress or Anxiety: Your history of anxiety and depression might contribute to these symptoms, especially under stress.

What you can do

  • Seek Immediate Medical Attention: It's crucial to see a healthcare provider as soon as possible to determine the cause of these symptoms. If they occur again, or if you feel unsafe, please call 911 or have someone take you to the emergency room.

  • Document Symptoms: Keep a record of your symptoms, including when they occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.

  • Stay Calm: If you experience these symptoms again, try to stay calm and focus on slow, deep breathing. Having a friend or family member with you can also help.

  • Follow Up on Mental Health: Since anxiety and depression can contribute to physical symptoms, consider discussing these episodes with your mental health provider.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare professional for a proper diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What are the common symptoms of a seizure?

Common symptoms of a seizure can include convulsions, muscle twitching, loss of consciousness, confusion, and sometimes sensory disturbances like visual changes. Seizures can vary widely in their presentation depending on the type and cause.


Can anxiety or panic attacks cause physical symptoms like convulsions and tremors?

Yes, anxiety or panic attacks can cause physical symptoms such as shaking, tremors, teeth chattering, and a feeling of losing control. These symptoms are often a result of the body's 'fight or flight' response to stress.


What is a transient ischemic attack (TIA) and how does it differ from a stroke?

A transient ischemic attack (TIA) is often called a 'mini-stroke' and occurs when there is a temporary disruption of blood flow to the brain. Unlike a stroke, the symptoms of a TIA are temporary and usually resolve within 24 hours without permanent damage. However, a TIA is a warning sign of potential future strokes.


How can chronic pain and mental health conditions like anxiety and depression affect physical health?

Chronic pain and mental health conditions like anxiety and depression can significantly impact physical health. They can lead to increased stress, which may exacerbate physical symptoms, affect sleep, and reduce overall quality of life. Managing these conditions with appropriate treatment can help improve both mental and physical well-being.


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Arora (Bot)#28060

3 mo ago

Based on your symptoms, there are a few possibilities such as seizure activity, panic attacks, or a neurological event. It's important to seek immediate medical attention to determine the cause. Documenting your symptoms and staying calm can also help. If you have questions about specific parts of the assessment, feel free to ask!

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