Neurological Symptoms: Leg Cramps, Seizures, and Medication Effects

Cranial nerves

Since experiencing my first leg cramp at the age of twenty-five, which triggered a seizure and caused me to faint, I have had recurrent symptoms.
By the age of twenty-eight, after a second episode, I frequently experience cramps in my right calf as soon as I fall asleep.
In severe cases, I am unable to move my entire body, cannot call out, and suffer from intense seizures in my brain that lead to fainting.
Upon waking, I feel weak all over, with rapid breathing and weakness in both legs.
Since last year, due to exam stress, I have been experiencing almost daily cramps in my right calf.
I have visited several large hospitals in Taipei and undergone EEG and CT scans of my brain, all of which showed no abnormalities.
I have intermittently taken anticonvulsants, and recently, following my doctor's advice, switched to clonazepam and alprazolam.
Initially, these medications seemed effective, but my condition worsened again (what could be the reason?).
I then reverted to taking anticonvulsants, which are effective but leave me feeling bloated, dizzy, and uncomfortable throughout the day, along with a decline in memory (which I did not experience before).
What is my condition? What could be the cause? Why do I feel uncomfortable in my head after switching back to anticonvulsants? What are the side effects of anticonvulsants? Please clarify, thank you!

sophia, 40~49 year old female. Ask Date: 2000/09/18

Dr. Ding Xianwei reply Neurosurgery

Regarding the symptoms you described, there are many possible diagnoses; however, the most likely one is epilepsy.
Based on your symptoms, clonazepam and alprazolam are two medications that I am not very familiar with, but they are likely benzodiazepines with anticonvulsant properties.
Tegretol (carbamazepine) is also an anticonvulsant medication, and its side effects can include dizziness and discomfort.
Therefore, the symptoms you mentioned may be side effects of Tegretol.
I recommend seeking further treatment at a neurology department specializing in epilepsy at a medical center such as Veterans General Hospital or National Taiwan University Hospital.

Reply Date: 2000/09/18

More Info

Your situation is quite complex and involves multiple neurological symptoms, medication effects, and potential underlying conditions. Let’s break down your symptoms and the medications you’ve been prescribed to better understand what might be happening.

Understanding Your Symptoms
1. Leg Cramps and Seizures: The leg cramps you experience, particularly when falling asleep, could be related to several factors, including electrolyte imbalances, dehydration, or even stress and anxiety. The fact that these cramps escalate to full-body seizures and loss of consciousness is concerning and suggests that there may be a neurological component at play. Seizures can manifest in various forms, and the symptoms you describe—such as being unable to move, calling out, or experiencing severe pain—could indicate a generalized seizure or a focal seizure that spreads.

2. Postictal State: After a seizure, it is common to feel weak, disoriented, or fatigued, known as the postictal state. This could explain your feelings of weakness and shortness of breath after these episodes. The fact that you have been experiencing these symptoms frequently, especially under stress, suggests that your body may be reacting to both physical and psychological stressors.

3. Memory Issues: The memory problems you describe, such as difficulty recalling names or recognizing people, could be linked to the medications you are taking or the stress and anxiety you are experiencing. Cognitive side effects are common with many medications, particularly benzodiazepines like clonazepam and alprazolam, which can impair memory and concentration.

Medication Effects
1. Clonazepam and Alprazolam: Both of these medications are benzodiazepines, which are often prescribed for anxiety and seizure disorders. While they can be effective in managing symptoms, they also carry risks of dependence, tolerance, and withdrawal symptoms. The initial effectiveness you experienced may have diminished as your body adjusted to the medication, leading to increased anxiety and seizure activity.

2. Epilepsy Medications (e.g., "癲通"): If you are referring to a medication like lamotrigine or levetiracetam, these are often used to manage seizures. While they can be effective, they also have side effects, including dizziness, fatigue, and cognitive impairment. The "head fullness" and discomfort you are experiencing could be side effects of these medications, especially if you are taking them in conjunction with benzodiazepines.

3. Side Effects: Common side effects of epilepsy medications can include dizziness, fatigue, headache, and cognitive issues. If you are experiencing significant discomfort or cognitive decline, it is crucial to discuss this with your healthcare provider. They may need to adjust your dosage or consider alternative treatments.

Recommendations
1. Consult Your Doctor: Given the complexity of your symptoms and the medications you are taking, it is essential to have an open dialogue with your healthcare provider. Discuss your symptoms, the side effects you are experiencing, and any concerns about your current treatment plan.

2. Consider a Neurologist: If you haven’t already, it may be beneficial to consult a neurologist who specializes in seizure disorders. They can provide a more in-depth evaluation and may suggest additional tests or alternative treatments.

3. Lifestyle Modifications: Managing stress through relaxation techniques, regular exercise, and a balanced diet can also help reduce the frequency of seizures and improve overall well-being. Staying hydrated and ensuring you have adequate electrolyte levels can also help with leg cramps.

4. Medication Review: A thorough review of your medications is essential. Your doctor may consider tapering off certain medications or switching to alternatives that have a more favorable side effect profile.

In summary, your symptoms are multifaceted and likely influenced by both neurological and psychological factors. A collaborative approach with your healthcare providers will be crucial in finding an effective treatment plan that minimizes side effects while addressing your symptoms.

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