Seizures+chest and joint pain

[Buffheart]

Hi all! So I still have a month to go until I can see the neurologist, but just a few minutes ago I was thinking about something my GP asked me back in May when he said he thought I might be having seizures. Actually he didn't say anything. Rather he asked me if I ever have chest pains. And I told him "yes" because I do. Ever since I was little I have had random bouts of chest pains maybe once or twice a year. Probably no more than twice max. Basically what happens is I get very sharp stabbing pains in my chest. They usually go from just above my belly button to the very bottom of my neck. It feels like somebody is stabbing me with a knife. Although I don't notice any shortness of breath it is very painful for me to breathe when this happens and so I try to either hold my breath or breathe very shallowly so that my chest doesn't move. I can talk and am perfectly coherent as well. After a few minutes it passes on it's own. As crazy as it sounds I have become so use to it that I always thought it was normal, that everybody experienced that. Just like my "seizure like events" I always assumed it happened to everybody and thus never brought it up, even to my parents. I can remember being in elementary school, in class, and just praying for the pain to pass. There have been times where I considered calling 911, but I'm afraid that by the time they get there it will have passed and then they will call me a liar. I have also considered telling my parents, but they never believe me anyway.

After I told my GP about the chest pain he wrote something down and that was that. No referral to a cardiologist, no medication, no EKG's. Nothing. So I don't know whether I should be worried or not. I mean if he wasn't worried then maybe it's nothing. But then again my doctors have also ignored me before. I am going to bring this up to the neurologist, but I wanted to get some opinions. This hasn't happened since January-March 2011 time frame, but I still think about it sometimes.

For a couple of months I also noticed times where my heart would beat very loudly for a couple of beats (maybe 3) and then go back to normal. Then it would beat loudly, then go back to normal. This could happen several times in an hour, and then not happen again for a couple more hours. I only noticed it at night, but it has not happened much for the past 2-3 weeks. I am wondering if they could be autonomic seizures.

Since January of this year I have also noticed a lot of joint pain. My mother blames medication, but even after I stopped taking a couple of meds I still have a lot of joint pain. It is especially bad in my wrists and fingers, though it happens in pretty much every join. Wrists, fingers, ankles, toes, back, knees, shoulders, and elbows. I have not noticed it too much in my neck or hips. My mother has arthritis, but I'm only 20. That seems a bit too young for arthritis. Plus it has only shown in the past 6 months or so. I have brought it up with my mother, but she gets annoyed whenever I talk about medical issues. I have also been taking fish oil, but it doesn't help. The joint pain and insomnia also keep me up at night and the joint pain makes using the computer, or even just reading (which I love), very painful, so I have pretty much stopped. At least as far as reading goes.

Anyway, I am just wondering if you guys think it could be related to possible seizures, or something/s else. Honestly some days I feel like I am falling apart. I just hope that doctors can fix me.

[Nakamova]

Joint pain is side effect of a few of the anti-seizure meds, so that could be a factor. There are other possible causes (like Lyme disease for instance or rheumatoid arthritis) which I assume you and your GP have ruled out.

As for the chest pain, it could be cardiac-related, or it could be related to something else due to the role the vagus nerve plays in the body. The vagus nerve basically runs along the route you describe -- from bellybutton to neck and up into the brain. It plays a role in heart rates, breathing, sweating, digestion, and muscle movements in the mouth. It even connects to the inner ear. (And it's a big deal in epilepsy -- the VNS implant that is used to treat refractory seizures is an implant that stimulates the Vagus nerve.). The path of the vagus nerve means that chest pain can actually originate from another part of the body (like the stomach), making diagnosis of a specific cause a difficult process of elimination. If your chest pains are lasting more than a few minutes though, I would think that warrants follow-up testing. I recommend that you push your GP to refer you to a cardiologist so you can rule out any cardiac factors.