Am I Experiencing Epilepsy or a Brain Tumor? My Symptoms - Neurology

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Do I have epilepsy? Could I possibly have a brain tumor?


Hello Doctor, I have two questions to ask you, regarding headaches and epilepsy.
Most importantly, I am very worried that I might have a brain tumor or something similar, and I hope to receive some advice.

Regarding epilepsy, I have been experiencing muscle fasciculations and persistent twitching of my left lower eyelid.
During severe episodes, it can twitch more than ten times in an hour, but the movements are very small, mostly only noticeable to me.
Others can't really see it.
In the past, I was concerned that it might be related to amyotrophic lateral sclerosis (ALS), so I underwent electromyography (EMG) and other tests, but there were no abnormalities (though it’s possible that the tests did not capture the issue at that time).
My sleep quality is very poor; I have light sleep and often dream, especially when I first fall asleep, frequently waking up from nightmares.
In severe cases, I wake up feeling completely numb and extremely panicked, making it hard to go back to sleep.
Sometimes, I feel like I suddenly can't breathe in my dreams, and my heart races as if it might explode.
My reaction in the dream is often, "Am I going to die?" When I sleep with my sister, if she notices my abnormal breathing and wakes me up, the subsequent issues do not occur.

Sometimes in my dreams, I feel my lips or tongue twitching, usually for a short duration (perhaps less than 30 seconds?), and I have not been observed by others during these episodes, so I’m not sure if they could be interrupted by external stimuli.
After these episodes, I wake up immediately.
Occasionally, I want to get up but find that my body won’t move; my consciousness is awake, but my body does not respond.
If I force myself to get up, I feel slight tremors throughout my body, but if someone calls or taps me, I can get up immediately.

I used to think these were just dreams and that my body did not react in reality, but once, while sleeping next to my mom, I had a nightmare and felt my heart racing, followed by my body starting to tremble.
At that moment, I heard my mom ask, "Why are you shaking?" and I seemed to quickly respond, "I had a nightmare." This made me realize that what I thought was happening in my dreams might also be occurring in reality, influenced by my physiological state.
Previously, I didn’t know the reason for this and thought it might be palpitations, sleep disorders, or anxiety.
Recently, after the passing of the panda Tuan Tuan, my curiosity led me to Google what epilepsy is, and I found that my symptoms might be explained by seizures.
I had previously thought that epilepsy only involved severe convulsions, loss of consciousness, and foaming at the mouth, so I hadn’t considered this possibility or undergone related tests.

Now, analyzing my situation, I often experience nightmares and panic when falling asleep, occasional twitching of localized muscles in my dreams (which happens rarely), or full-body shaking in dreams (which is very rare; I recall only two instances recently, usually preceded by significant discomfort in my chest).
These occurrences, aside from muscle twitching, only happen during sleep, and I am aware of what is happening in the external environment, which causes me to wake up.
Could this be considered mild epilepsy? If it’s not caused by a brain tumor and I feel it doesn’t significantly affect my daily life, do I still need treatment? Will it worsen?
Regarding the headaches, ever since I suspected I might have epilepsy and that it could be caused by a brain tumor (like Tuan Tuan?), I have been feeling extremely stressed and scared, which has led to headaches that feel tight all around, though they do not significantly impact my daily life.
Whenever I feel anxious, I experience various physical reactions, such as gynecological issues and gastrointestinal problems.
I have also experienced dizziness in the past.
Each time I Google my symptoms, I end up reading about cancers, which increases my fear and makes my body feel increasingly abnormal.
However, visits to the hospital have not yielded significant results, just some symptomatic treatments or diagnoses of autonomic nervous system disorders, and sometimes I am prescribed anti-anxiety medication.

In the past two days, I have felt very anxious, with tightness in my head, neck, and shoulders.
Sometimes, I experience tingling in my scalp or feel cold, along with a dry throat and a sensation of something stuck in my throat.
These symptoms are likely psychosomatic, but I also occasionally experience brief headaches, usually on the left side, which can extend to my neck or shoulder, resembling a pulsating pain that lasts for a few seconds.
This has occurred very rarely in the past two days, and I am unsure of the cause (could it be a brain tumor, especially since my eyelid twitching is also on the left side)? I read that migraines tend to last longer.

I truly appreciate your time in reading this lengthy message.
I am very worried that I might have epilepsy or a brain tumor.
When I mention to my family that I want to see a doctor, they think I am just staying up late or being picky with food, telling me to normalize my routine, exercise more, or see a psychologist.

P.S.
I have been dealing with sleep disorders and muscle twitching for many years; my first visit to a doctor was in high school.
The left-sided headache issue has only been noticed in the past 1-2 years.

So my questions are: 1.
Is it possible that I have epilepsy? 2.
Why do I have headaches? 3.
Is there a significant possibility of a brain tumor? Should I really get checked out or see a psychologist? Thank you, and I wish you peace and health!

Classmate C, 20~29 year old female. Ask Date: 2022/11/30

Dr. Cai Zongzhang reply Neurology


Hello, Student C: The symptoms mentioned may be related to sleep apnea.
It is recommended to visit a neurologist for a detailed examination to determine the underlying cause.

Reply Date: 2022/11/30

More Info


Your concerns about experiencing symptoms that may be related to epilepsy or a brain tumor are understandable, especially given the complexity of your symptoms. Let's break down your questions and symptoms to provide a clearer understanding.


1. Could this be epilepsy?
The symptoms you've described, such as muscle twitching (myoclonus), eyelid twitching, and episodes of panic upon waking, can indeed be concerning. However, it’s important to note that not all muscle twitches or spasms indicate epilepsy. Epilepsy is characterized by recurrent seizures, which can manifest in various forms, including generalized tonic-clonic seizures (the classic convulsions) and focal seizures, which may not involve loss of consciousness.
Your experiences of waking up in a panic, feeling your heart racing, and having muscle twitches could potentially be linked to sleep disorders, such as sleep apnea or REM sleep behavior disorder, rather than epilepsy. The fact that these symptoms occur primarily during sleep and are often accompanied by vivid dreams or nightmares suggests a possible sleep-related issue.
Since you have already undergone an electromyography (EMG) test that returned normal results, this is a positive sign that there may not be a significant neurological disorder at play. However, if you continue to have concerns about epilepsy, it would be prudent to consult a neurologist for further evaluation, which may include an EEG (electroencephalogram) to monitor brain activity.


2. What about the headaches?
Headaches can arise from various causes, including tension, migraines, or even anxiety. Given your description of feeling tightness around your head and experiencing anxiety, it’s possible that your headaches are tension-type headaches, which are often exacerbated by stress and anxiety. The tightness in your neck and shoulders could also contribute to these headaches.

The brief, pulsing pain you described on the left side of your head could be a form of migraine or even a tension headache. Migraines can sometimes present with aura or sensory disturbances, which might explain some of your experiences. However, if the headaches are new, persistent, or worsening, it’s essential to consult a healthcare provider to rule out any serious conditions.


3. Is there a significant risk of a brain tumor?
While it’s natural to worry about serious conditions like brain tumors, the likelihood of having one based solely on your symptoms is relatively low, especially if you have had normal imaging studies and neurological evaluations. Brain tumors typically present with more pronounced neurological deficits, such as changes in vision, speech difficulties, or significant cognitive changes.
That said, if you have persistent symptoms that concern you, it’s always best to seek further evaluation. A neurologist can assess your symptoms in detail and may recommend imaging studies, such as an MRI, to rule out any structural abnormalities.


Conclusion and Recommendations
1. Consult a Neurologist: Given your symptoms, a thorough evaluation by a neurologist is recommended. They can perform necessary tests, including EEG and possibly MRI, to assess for epilepsy or other neurological conditions.

2. Sleep Evaluation: Consider discussing your sleep issues with a sleep specialist. Sleep disorders can significantly impact your overall health and may explain some of your symptoms.

3. Manage Anxiety: Since anxiety seems to exacerbate your symptoms, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) or other therapeutic approaches can be beneficial in managing anxiety and its physical manifestations.

4. Lifestyle Modifications: Improving sleep hygiene, managing stress through relaxation techniques, and maintaining a healthy lifestyle can also help alleviate some of your symptoms.

Remember, while it’s important to be vigilant about your health, it’s equally important to approach your concerns with a balanced perspective. Seeking professional guidance will provide you with the clarity and reassurance you need. Take care, and I wish you the best in your journey toward better health.

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