What Causes Heat Sensation In Heart Radiating To Extremities?

Brief Answer:
Your sypmtoms seem to be related to epileptic seizures with epigastric aura

Detailed Answer:
Hello!

Thank you for asking on HCM!

I read your question carefully and understand your concern.

Your symptoms seem to be related to an epileptic seizure or a panic disorder.

I would like to know more about your previous seizures and the time of your beginning. Referring to your past medical history, positive for seizures, these episodes are probably partial seizures.

There are different types of seizures. The symptoms you describe are very similar to an epigastric aura, typical for temporal lobe epilepsy (which is a partial epilepsy).

The problems with your taste (menthol feeling) in the mouth are too related to the deep temporal lobe, where lay the brain centers responsible for the taste.

It is true that energy drinks can trigger a seizure, but also a panic attack.
But an autoimmune disorder, causing an inflammatory reaction of the body, could also exacerbate seizures.

A brain MRI and an EEG would be very important for the differential diagnosis between a seizure and a panic attack and to identify a possible intracranial cause (a lesion in the deep temporal lobe).

Other tests like: a routine blood test, inflammation tests (fibrinogen, PCR, sedimentation), kidney and liver function tests, thyroid hormone levels, blood electrolytes, are needed to establish the possible cause of these episodes (or seizure exacerbation).

Other specific tests for autoimmune disorders (ANA, XXXXXXX ENA, RF, etc) should be performed after consulting with a rheumatologist, to investigate for any possible connective tissue disorder and the treatment options.


If after the EEG, it is concluded for seizures, I recommend discussing with your attending physician the possibility of a dose change to Keppra therapy (this is a small dose) or to add another antiepileptic drug (like carbamazepine, oxcarbazepine,etc).


Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best wishes,
Dr. Iliri

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Brief Answer:
I recommend performing further tests to establish the diagnosis

Detailed Answer:
Hello again!

Thank you for the information provided!

Temporal lobe epilepsy with epigastric aura not always show EEG changes, because the epileptic focus lays deep in the brain and the distance between the electric discharges and the EEG electrodes may be not short enough to detect these discharges in the EEG.

Your past medical history for seizures is a little concerning.

It is necessary to perform a continuous 24 hour EEG, to exclude the seizure occurrence.

From the other hand anxiety could mimic this clinical scenario as well.

Pheochromocytoma is another disorder which can simulate panic attacks, but is also associated with other symptoms like episodic uncontrolled high blood pressure, face flushing etc.

If the urine tests result normal, this disorder can be excluded.

If the MRI and 24 hour EEG result normal, I recommend consulting with the psychiatrist to consider the possibility of starting an antidepressant (SSRI), which are very effective against anxiety.

This could serve also as a therapeutical test, because it is known that antidepressants can decrease anxiety and the frequency of panic attacks, but can exacerbate epileptic seizures.

If such complication occurs, it may be because of hidden epileptic fosus in the brain , undetectable by the EEG or MRI and a higher dose of levetiracetam may be necessary, besides stopping the antidepressant.

Hope to have been of help!

I am at your disposal for further questions, whenever you need!

Greetings! Dr. Iliri

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Brief Answer:
I recommend making changes to your anti epileptic therapy

Detailed Answer:
Hello again!

I am glad to have been helpful!

The episodes of high BP and face flushing may be related to the higher serotonin levels in your blood caused by celexa intake.
It seems to have been serotoninergic syndrome.

Taking into consideration this information, I recommend consulting with your attending physician on the possibility of adding another anti epileptic drug like carbamazepine or oxcarbazepine to your therapy, or increasing the dose of levetiracetam, despite your normal EEG.

Best regards,
Dr.Iliri

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Brief Answer:
I recommend performing vitamin B12 plasma levels

Detailed Answer:
Hello again!

Thank you for the information provided.

It is true that vitamin B12 deficiency can be associated with your changed perception in the tongue (also called dysgeusia) and can be the cause of seizures exacerbation.

But it would also be associated with chronic megaloblastic anemia and other symptoms like numbness in the limbs, etc..

I advise performing vitamin B12 plasma levels to exclude this possibility.

Regarding anxiety, if all the tests result normal, it remains the most probable diagnosis.

I hope to have fulfilled all your expectations!

Best wishes,

Dr. Iliri

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