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I’ve Endured Acute Episodes Throughout The Past 18 Years (several

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Posted on Thu, 19 Mar 2020
Question: I’ve endured acute episodes throughout the past 18 years (several per year on average) which were minor to moderate in severity. Occasionally I have severe flare ups with the following symptoms:

-Severe anxiety and panic attacks (debilitating)
-Heart palpitations, fast pulse
-High blood pressure, 150s to 160s over 90
-Severe widespread muscle pain and muscle twitching
-Headaches
-Sweaty palms
-Insomnia

Duration:
Over a period of 1 to 2 weeks the frequency of symptoms decreases as well as the severity.

Triggers:
My GP has chalked it up as GAD/Panic Disorder but I’m still wondering if there is an underlying medical cause. Anxiety/panic attack symptoms are generally attributed as psychiatric in nature and related to chronic worrying, but I can tell you that is not the root cause here. I’m generally not a worrier although I have to admit this condition has caused some health anxiety.

My personal experience is that these episodes usually seem to occur after a drug, vitamin, or nutritional supplement that I’ve been taking triggers my nervous system to become hyperactive and over-sensitized. For example, I’ve experienced this even taking common health supplements such as fish for example, over a period of weeks I began to experience increased anxiety, muscle twitching and widespread pain. If I cease then over a period of 3-5 days I return to baseline. Recently, discontinuing Lipitor caused a very severe acute episode. Granted, statins can cause discontinuation syndrome from what I’ve read, but the flare up was consistent from my previous experiences from this condition albeit much more severe.

What it’s apparently not:
I’ve had electromyography and a nerve conduction study in the past and results were unremarkable, and I have no muscle weakness either. I’ve also been tested for pheochromocytoma which was negative. Thyroid tests were normal, no abnormal blood markers except for low vitamin D, elevated cholesterol and somewhat low testosterone.

Questions:
1)     Have you seen or heard of this before?
2)     Is this somehow a psychiatric problem, or is there likely a neurological medical cause (nervous system disorder or autoimmune perhaps)?
3)     What testing would you recommend?
doctor
Answered by Dr. Dr. Erion Spaho (4 hours later)
Brief Answer:
Most likely psychological, but a neurological disorder to be excluded first.

Detailed Answer:
Hello and welcome to 'Ask A Doctor' service.

I have read your query.

The possibility that yours to be a neurological condition seems unlikely since it is going for too long now and the tests didn't justify this etiology.

However, one condition may mimic symptoms like yours in rare cases.

This may be multiple sclerosis (MS), and I think a brain and spinal cord MRI is necessary to evaluate it properly and even to exclude it.

If MS will be excluded then yours is most likely a case of psychological origin combined with any hypersensitivity to food or drug components.

Discuss with your Neurologist for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4500 Questions

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I’ve Endured Acute Episodes Throughout The Past 18 Years (several

Brief Answer: Most likely psychological, but a neurological disorder to be excluded first. Detailed Answer: Hello and welcome to 'Ask A Doctor' service. I have read your query. The possibility that yours to be a neurological condition seems unlikely since it is going for too long now and the tests didn't justify this etiology. However, one condition may mimic symptoms like yours in rare cases. This may be multiple sclerosis (MS), and I think a brain and spinal cord MRI is necessary to evaluate it properly and even to exclude it. If MS will be excluded then yours is most likely a case of psychological origin combined with any hypersensitivity to food or drug components. Discuss with your Neurologist for these issues. Hope you found the answer helpful. Let me know if I can assist you further.