[41M] Experiencing episodic neurological and cardiovascular symptoms

Patient Description

A 41-year-old male reports experiencing sudden, short-lived episodes of tingling in the face and tongue, particularly triggered by faster movements or standing. These episodes are accompanied by heart palpitations, blurred vision, buzzing in the ears, an electric shock sensation in the head, slight loss of balance, and weakness, but no difficulty speaking. The symptoms have been more frequent today, occurring almost every time he moves over the past hour, whereas they typically resolve within 10-15 minutes. The patient has a history of epilepsy, currently awaiting a refill of Vimpat, and notes increased stress due to recent election results. He also has a history of Postural Orthostatic Tachycardia Syndrome (POTS) and Ehlers-Danlos Syndrome (EDS), which limit his ability to exercise due to pain and fatigue. The palpitations are more frequent in the mornings and worsen with physical activity.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, several conditions could be contributing to what you're experiencing:

  1. Postural Orthostatic Tachycardia Syndrome (POTS): Given your diagnosis of POTS, the heart palpitations, tingling, and loss of balance when standing or moving quickly could be related to this condition. POTS can cause your heart rate to increase significantly upon standing, leading to symptoms like dizziness, palpitations, and sometimes tingling due to changes in blood flow.

  2. Epilepsy and Medication: The tingling, buzzing in the ears, and electric shock sensations could be related to your epilepsy, especially since you're waiting for a refill of your medication. These sensations might be a form of aura or partial seizure activity.

  3. Stress and Anxiety: The additional stress you're experiencing could exacerbate your symptoms, including heart palpitations and blurred vision. Stress can also trigger or worsen migraine symptoms, which you are prone to.

  4. Migraine: The blurred vision and buzzing in the ears could be related to migraine activity, which can be triggered by stress or changes in routine.

What you can do

POTS Management:

  • Increase your fluid and salt intake to help manage POTS symptoms, but consult your doctor for specific recommendations.
  • Consider wearing compression garments to improve blood flow and reduce symptoms when standing.
  • Use MDandMe to track your symptoms and identify any patterns or triggers.

Epilepsy and Medication:

  • Contact your healthcare provider about your medication refill as soon as possible to prevent further episodes.
  • Avoid known seizure triggers, such as lack of sleep or stress, as much as possible.

Stress Management:

  • Practice stress-reduction techniques such as deep breathing, meditation, or gentle yoga.
  • Ensure you have a support system in place to help manage stressors.

General Tips:

  • Avoid sudden movements and take your time when transitioning from sitting to standing.
  • Keep a symptom journal using MDandMe to track episodes and share with your healthcare provider.

What you should look out for

  • If you experience prolonged or worsening symptoms, such as severe dizziness, chest pain, or confusion, seek medical attention immediately.
  • Monitor for any new or unusual symptoms, especially if they persist or worsen.
  • Ensure you have a plan in place for managing your epilepsy, especially during times of increased stress or medication changes.

Remember, while this advice is based on the information provided, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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1 mo ago


People Also Ask


What is Postural Orthostatic Tachycardia Syndrome (POTS) and how does it affect daily life?

POTS is a condition that affects circulation (blood flow). It involves the nervous system and is characterized by an excessive increase in heart rate when standing up. This can lead to symptoms like dizziness, palpitations, and fatigue, making daily activities challenging.


How can stress and anxiety exacerbate symptoms in individuals with epilepsy or POTS?

Stress and anxiety can increase the frequency and severity of symptoms in individuals with epilepsy or POTS by triggering physiological responses that exacerbate heart palpitations, seizures, or dizziness. Managing stress through relaxation techniques can help mitigate these effects.


What are some effective strategies for managing symptoms of Ehlers-Danlos Syndrome (EDS)?

Managing EDS involves a combination of physical therapy to strengthen muscles and improve joint stability, pain management strategies, and lifestyle modifications to avoid activities that cause joint strain. Regular consultations with healthcare providers are essential for personalized care.


How can one safely manage exercise and physical activity with conditions like POTS and EDS?

For individuals with POTS and EDS, it's important to engage in low-impact exercises like swimming or cycling, which are less likely to cause joint pain or exacerbate symptoms. Gradual increases in activity level, under medical supervision, can help improve tolerance and overall fitness.


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