Discussions By Condition: I cannot get a diagnosis.

Leg Seizures

Posted In: I cannot get a diagnosis. 6 Replies
  • Posted By: dawnjarod
  • December 29, 2008
  • 01:33 AM

My father has leg seizures, sciatic pain, numbness in his hands, back pain. He doesn't sleep. He was diagnosed with restless leg syndrome years ago but now they don't believe it's that. No one seems interested in getting to the bottom of it. He sleeps maybe 3-5 hours a night and his legs seizure multiple times a day for sometimes hours at a time. We don't know what to do. He's had CT scans, MRI's, EKG's and they say they haven't found anything. Any help or suggestions would be greatly appreciated.

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  • Okay, let's see if we can gain some clarification of what you mean by leg "seizures." When we speak of seizures in the most common clinical sense, we're referring to refractory seizure activity that is the consequence of certain abherent electrical activity in the brain. As such, the body in general is most often affected rather than a single extremity or muscle group, although there are exceptions that don't require mention here. Restless Leg Syndrome, by contrast, is a condition wherein the affected person feels compelled to move the legs about, most often in the early evening and bedtime and is commonly accompained by pain and other sensory disturbances. Nocturnal leg cramps are very common among the elderly and typically arise as a consequence of dehydration or electrolyte imbalances. The calf muscle is the muscle most affected, but other muscle groups can be involved as well. So some clarification as to precisely what his symptoms are would be of great value since we don't have the crucial benefit of direct examination. You also mention that he is experiencing sciatic pain and other back pain as well. Can you tell me more specifically where the back pain is located, whether it varies in intensity or is steady, and how long the back pain has been present by comparison to the RLS? Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • December 29, 2008
    • 02:27 AM
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  • The doctors are saying they believe that they are seizures, his legs actually jump off the ground, bed. His sciatic pain starts in his buttocks and shoots down both legs, this is a new symptom in the last 2 weeks. He has had neck pain for years. I'm not sure of the intensity. He has a high pain threshold.
    dawnjarod 2 Replies
    • December 30, 2008
    • 04:43 AM
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  • Ah, okay. The unintentional movement of his legs would more likely be myoclonic jerks than anything to do with seizures. Myoclonic jerks and hyperreflexia can occur in persons with spinal disc injuries or disorders and although I'm aware of the pain distribution of sciatica, I was more speaking to the matter wherein you mentioned both back pain and sciatica in your original posting. Is the sciatica the only back pain he is experiencing, or is there other pain involved besides his neck? Is the seizure activity that occurs for sometimes hours a symptom that you've observed for hours or something that he's describing to you? I ask not to doubt the veracity of the claim, only that very specific information must be obtained to distinguish between multiple factors that can occur with symptoms such as those being described. Again, true seizure activity would not be restricted to the legs and I'm also curious to know whether there is any muscular weakness either when the seizures are present or in their absence? Does the physician's report actually state leg seizures or is it a term they are using to offer a more simplified description of what is actually taking place in the clinical sense? Once we can get a better idea of more precisely what seizures represents in this case, a better direction can be offered. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • December 30, 2008
    • 00:45 PM
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  • Following is a brief summary from my father. I'm concerned that the symptoms are multiplying ie the numbness in the hands. He doesn't talk here about the sciatic pain but I can have him describe that too if that would be helpful. I guess what I'm looking for is what type of doctor should he see. He seems to be getting stonewalled. Thank you for any help you can provide. Dawn Hilliard I am currently taking Requip 6 mg a day at 2 PM, 6 PM and 10 P.M. and Topamax 25 mg 4 times a day 6 AM, 12 Noon, 6 PM amd Bed time after 10 PM. The myoclonic jerks occur mostly in the afternoon and evening anywhere from 1 PM on and can last for an hour or two to eight to ten hours depending. Activity can vary the attacks but may not necessarily be the trigger. I definitely have bulging disks ay lumbar 4-5 and cervical 3,4,5 but the most serious damage is in the thorasic region where the spinal chord seems to be squeezed. It feels as though an electrical shock is causing my leg to ***k uncontrollably with pain and sometime I get charlie-horses with it now. My legs seem to be getting weaker as time goes by as a result of the attacks. The medication seems to mask the symptoms, but I am not convinced that it is really controlling the symptoms. Occasionally my arms will ***k as well but not as often as my legs. The new symptom occurring is my hands and fingers are going numb almost everyday and especially out in the cold. When this occurs I have pain radiating from my back to shoulders.I have constant pain in the ball of my feet and I get serious cramps and intense pain when experiencing the myoclonic jerks in my legs. The Neurologist at Hershey has said that they are going to just treat me with the Topamax and not have the surgeon look at the thorasic MRI at this time! I have the appointment Febnuary 19th with a Neuomuscular Specialist at Lankenau Hospital in Philadelphia. Paroxetine 10mg QD {Breakfast} Requip 2mg QID muscle spasms { Lunch, Dinner & Bedtime} Lisinopril 40mg., SAN, QD {Breakfast} Cialis 20 mg, when needed – E.D. Triamt/hctz 37.5 – 25 25mg QD {Breakfast} Prevacid {over the counter} QD Aspirin 81 mg, QD – thin the blood {Breakfast} Multivitamin, QD {Breakfast} Furosemide 40mg MYLAN QD {Breakfast} Potassium 99 mg QD {Breakfast} Fish Oil 1200mg BID {Breakfast, Dinner} Topamax 25mg QID (Breakfast, Lunch, Dinner. Bedtime) SURGERIES - HOSPITALIZATIONS2001 – Orthroscopic knee surgery – right knee – knee cap porous on back Attack of Atrial Fibrillation twice in a week 72 hours hospital stay2002 – Nasal surgery – sleep apnea – same day surgery Gall bladder – non evasive – repaired umbilical hernia – same day surgery2004 – Hydrocele – right testical – same day surgery Sleep Test for Sleep Apnea – over night Vasectomy – doctors office2005 – Visits to the emergency room – approx. every three weeks for five or months with Atrial Fibrillation and Tachycardia. Medication usually converted – once eight to ten hours and I was cardio-verted – successfully.2006 – January – Doylestown Hospital – Surgical Oblation – no Atrial Fibrillation or Tachycardia since the surgery. May – spider nerves surgically removed from my left foot – Morton’s Neuroma2008 – January 1st – Emergency room, fell on ice, lumbar strain.2008 – May – June 2008 – 16 treatments DRX6000 machine – like traction and injections, no response.2008 – 3 MRI’s on my back – cervical, thoracic and lumbar, EEG, EMG, Lumbar puncture, various blood tests twice.
    dawnjarod 2 Replies
    • January 1, 2009
    • 07:51 PM
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  • Paroxetine side effectsGet emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself. Call your doctor at once if you have any of these serious side effects:seizure (convulsions);tremors, shivering, muscle stiffness or twitching;problems with balance or coordination;agitation, confusion, sweating, fast heartbeat; oreasy bruising or bleeding (such as a nosebleed).Also, using the drug interactions checker on www.drugs.com I found this red flag:Interactions between your selected drugshttp://www.drugs.com/images/s3.jpg triamterene (Ingredient of triamterene-hydrochlorothiazide) and lisinopril (Major Drug-Drug)MONITOR CLOSELY: Concomitant use of angiotensin converting enzyme (ACE) inhibitors and potassium-sparing diuretics may increase the risk of hyperkalemia. Inhibition of ACE results in decreased aldosterone secretion, which can lead to increases in serum potassium that may be additive with that induced by potassium-sparing diuretics. The interaction may be mild in most patients with normal renal function. In a retrospective review of 127 patients treated with captopril, some of whom also received a potassium-sparing diuretic or a diuretic with a potassium supplement, no association was found between captopril use and changes in serum potassium levels. In another retrospective study, enalapril was shown to have no effect on the serum potassium of 16 patients who were taking furosemide or amiloride, and there was no difference in serum potassium levels of the group taking enalapril with diuretics compared to a similar group not taking enalapril. However, life-threatening and fatal hyperkalemia have been reported to occur within days to weeks of receiving the combination in patients with risk factors such as renal impairment, diabetes, old age, severe or worsening heart failure, and concomitant use of potassium supplements or other medications that increase serum potassium. Both ACE inhibitors alone and diuretics alone have been associated with hyperkalemia in patients with renal impairment. ACE inhibitors may also cause deterioration of renal function in patients with chronic heart failure, and the risk is increased if they are sodium-depleted or dehydrated after excessive diuresis.MANAGEMENT: Caution is advised if ACE inhibitors are used with potassium-sparing diuretics, particularly in patients with renal impairment, diabetes, old age, worsening heart failure, and/or a risk for dehydration. Serum potassium and renal function should be checked regularly, and potassium supplementation should generally be avoided unless it is closely monitored. Patients should be given dietary counseling and advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as weakness, listlessness, confusion, tingling of the extremities, and irregular heartbeat. If spironolactone is prescribed with an ACE inhibitor, some investigators recommend that its dosage not exceed 25 mg/day.Your dad is on quite a cocktail of meds...drug interaction should be thoroughly looked at and ruled out. Best wishesDOM
    acuann 3080 Replies
    • January 1, 2009
    • 11:30 PM
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  • Okay, thank you for an excellent description and further clarification of the symptoms. Based upon the symptoms, I would call the problem with his legs spinal myoclonus, more specifically segmental myoclonus and your comments further suggest some spinal stenosis. I would agree that the Topomax and Requip will do little to actually control this type of problem and at some point Neurology and Surgery will have to put their heads together with a better patient plan to resolve the issue to a more permanent extent. If there is stenosis with some cord or outlet compression, surgery will likely exist as the most likely course to proceed at the proper time. Under the circumstances, your medication list seems fairly bland. I don't see anything here that would be contributory by comparison to the obvious mechanical issues associated with the spinal column that would actually more represent the causal factor related to the myoclonus. While I do subscribe to the most non-invasive approach first to determine whether the problem can be successfully controlled, we likely have a situation here that will require surgical intervention in my opinion in order to obtain permanent relief of some type. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 2, 2009
    • 01:25 AM
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