Autonomic Nervous System Disorders: Symptoms and Concerns

I would like to inquire about "autonomic nervous system dysfunction."

Hello: Yesterday, my classmate called me and told me that his roommate was "possessed." When I arrived, I was taken aback; her hands were trembling uncontrollably, resembling seizures.
She felt as if someone was choking her with a rope, and her breathing was extremely difficult.
Her gaze was vacant, unlike her usual self, and her speech was very unclear, as she spoke a lot of things we couldn't understand.
When I asked her questions, she could only respond by blinking to indicate yes or no.
At one moment, she was crying in my arms, pleading for help; then suddenly, she pushed me away with a fierce look in her eyes.
She would faint and then wake up again, truly resembling someone who was "possessed." Prior to this, she kept saying she saw a woman, referring to the so-called "good brothers" in folklore, and mentioned that she had been experiencing pressure on her chest for several days.
Since she has a fixed religious belief, I felt it was inappropriate to say much...
In a situation like this, could it be a mental illness? I am very worried about her, as the episode lasted for almost four hours before she fully regained consciousness.
However, when I asked her if she remembered what had just happened, she did recall everything...
She kept saying she felt controlled.
Is this a case of autonomic nervous system dysfunction? Or is it something else...?

Hei Jiali, 20~29 year old female. Ask Date: 2004/04/01

Dr. Ye Boshou reply Neurology

Please first see a psychiatrist for an evaluation.

Reply Date: 2004/04/01

More Info

Your friend's symptoms are indeed concerning and could be indicative of a serious condition. While I cannot provide a definitive diagnosis, I can help clarify some aspects related to autonomic nervous system (ANS) disorders and the potential implications of her symptoms.

The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, respiration, digestion, and sexual arousal. It is divided into the sympathetic nervous system (which prepares the body for 'fight or flight' responses) and the parasympathetic nervous system (which promotes 'rest and digest' functions). Disorders of the ANS can lead to a variety of symptoms, including but not limited to heart palpitations, excessive sweating, digestive issues, and muscle tremors.

In your friend's case, the symptoms of uncontrollable shaking, difficulty breathing, altered consciousness, and erratic behavior could suggest a few possibilities:
1. Panic Attack or Anxiety Disorder: These conditions can cause intense physical symptoms, including trembling, shortness of breath, and feelings of losing control. Panic attacks can also lead to dissociative experiences, where individuals feel detached from reality.

2. Seizure Activity: The description of her hands shaking uncontrollably and the episodes of losing consciousness could suggest a seizure disorder. Seizures can manifest in various ways, including convulsions, altered awareness, and unusual behaviors.

3. Psychogenic Non-Epileptic Seizures (PNES): These are episodes that resemble seizures but are not caused by electrical disruptions in the brain. They can be triggered by psychological stress or trauma and may involve shaking, loss of awareness, and confusion.

4. Dissociative Disorders: The experience of feeling controlled by an external force and the inability to recall events during the episode may indicate a dissociative disorder, which can occur in response to severe stress or trauma.

5. Substance Use or Withdrawal: If your friend has been using substances, either recreationally or as part of a treatment plan, withdrawal or intoxication could lead to similar symptoms.

Given the complexity of her symptoms and the duration of the episode, it is crucial for her to seek immediate medical attention. A healthcare professional can conduct a thorough evaluation, including a neurological examination, psychological assessment, and possibly imaging studies or blood tests, to determine the underlying cause of her symptoms.

In the meantime, it is essential to provide support and reassurance to your friend. Encourage her to talk to a mental health professional who can help her process any underlying issues that may be contributing to her distress. If she experiences another episode, it may be necessary to call emergency services to ensure her safety and receive prompt medical care.

In summary, while autonomic nervous system disorders can manifest in various ways, your friend's symptoms may also point to other serious conditions. A comprehensive evaluation by healthcare professionals is essential to determine the appropriate diagnosis and treatment plan.

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