Any ideas what this could be?

[sjconner]

I went to the ER last Thursday. My left shoulder started twitching/convulsing/contracting. It progressed from just contractions to contractions with an inward (toward the center of my chest) movement. Then it went from just those movements and added a left downward and and center movement. I don't know how long the progression took. It started really hurting. About an hour after they first started, I finally went to the ER. The movements just wouldn't stop. To get them to stop, I tried singing to myself, relaxation techniques, finding stuff to do where I needed that arm, etc.

During this time, at work, our power had gone out and I got the keys to the supply room. I went into a totally dark room without a flashlight looking for a flashlight. I remember doing that and it doesn't seem like something I would normally do. I don't remember some parts of the conversation I had at the ER with a friend who took me (before ativan).

I showed up at the ER at 1226. They gave me a 1mg dose of ativan at 12:46 pm. After this dose (at 1255 pm) "contractions slowing down but still present, right arm also starting to contract." At 1:05 pm, they then gave me another 1 mg dose of ativan. Right before this dose, my BP was 181/118. A couple of minutes before the convulsions stopped my BP was down to 137/88. Convulsions were finished at 1:20 pm. I took this info from the ER report. I slept most of the next day.

Yesterday, I went to the neurologist but my local hospital hadn't sent over the ER records. Today, I faxed them to him.

Why would my left arm start and then my right arm join in later (without legs, etc)? Any suggestions? I see the neurologist again in 4 weeks.

 

[Nakamova]

Sounds like myoclonic seizures -- have you had any of those symptoms before?

 

[sjconner]

Not that I am aware of. They kept going and going without pausing. The neuro upped my lamotrigine to 200 mg twice a day from 125 mg twice a day. He dropped the super low dose of gabapentin. I really thought I had bugs crawling all over me last night. I even checked my bed. Is this a side effect of the dose increase?

 

[Nakamova]

I haven't had that problem with a Lamictal increase, but who knows? I found some mentions online where people developed myoclonic jerks after going on Lamictal or increasing its dose, and twitching is listed as a possible Lamictal side effect. Was the increase from 250mg/day to 400mg/day done all in one go? If so, that's on the fast side and would be more likely to produce side effects than a slower ramp-up.

 

[sjconner]

That increase was last night. I had been at 125 mg lamotrigine twice a day since the beginning of July. On Thursday night, after being in the ER, they tried to increase from 125 twice a day to 125 three times a day. Yesterday, the neurologist just had me go to 200 twice a day. So a big jump in 5 days. Until last Thursday, I had been seizure free since the end of May.

 

[Nakamova]

Sorry about that, I misunderstood -- the jerking came before the Lamictal increase, so I guess it's not related to that. However the skin-crawling sensation could definitely be related to the increased dose. Hopefully it will wear off after your body adjusts.

Anything you can think of that might have triggered last Thursday's muscle jerks? Any changes in sleep, medications, stress levels, general health, dietary intake, etc.?

 

[sjconner]

onder:
Not really ... same stuff, different day. The neuro thought maybe stress but nothing new has happened or changed. If anything things have gotten better. Hubby is no longer working for himself = reliable paycheck! I got a raise. We are going to be able to expand our property.

I am at a total loss. My previous episodes have been simple (sensory) and complex partials (consciousness impaired).

 

[QueenieKP]

Muscle jerking could be myclonic seizures as mentioned. Any update from
your neuro as to his thoughts now he has the faxed info from ER?

Q

 

[sjconner]

Haven't heard anything. His partner is out until January. He is always running late ... for him it is a good thing. He takes time with his patients. A bit arrogant but very compassionate.