"Episodes" Types I've Had - What Are They?            4-13-04

It is with a bit of desperation that I post the following here! ;-)
During the last six months I've had various types of "episodes",
often many times a day. I will try to describe each separately
to see if people here have any ideas about what they are (I've
described them briefly as a group here before, but with little
response...). Common to all: I remain conscious; there is nothing
showing on a short EEG, a partial EEG taken as part of a sleep
study for Obstructive Sleep Apnea, or the same with 13 added
electrodes; these do not happen during sleep (as far as I know,
except for PLMS); they happen randomly, when alone or with
people, and when doing little or when busy, with few triggers
identifiable; I have not experienced depression except while on
Topamax and for a few isolated days in the last six weeks or
so; brain MRIs have been declared "essentially normal" by two
neurologists, but "showing several structural irregularities" by
another; all occurrences are essentially episodic (I have "normal"
periods). I have extensively searched on google, and I have
some ideas for some of what may be going on, but I would like
other opinions...

Type 1, "limps"--
This one is often preceeded by a visual image of a 1/2 second
closing of an "iris" (like in a lens) that closes out vision. It is roughly
egg-shaped (small end up) and at first it appeared with a bright
yellow "saw-tooth" edge against a dark background. Lately,
it appears darker-edged, against a medium brown background.
I think it is right-side only, but I'm not sure. I may see this several
times before the event, over maybe an hour's time, or I may only
see it just as the event begins to happen (not always, though).
Vision is normal immediately afterwards. The event that follows is
a loss of muscle-strength over many seconds that causes drooping
and an inability to move. This lasts for a few seconds (essentially
not happening) to several hours, with 10-minutes to an hour+
being the most common. I've had as many as 6-8+ of these a
day, though generally I have only 1-2 per day now. I am aware
of my surroundings (though my eyes are generally mostly closed),
but time passing is unimportant (even if many hours). At first,
surprise could put me into this, but lately petting a cat or eating
are the most likely identifiable things that often do it - but the
majority of these events appear randomly. I sometimes stop
breathing or breath very shallowly during these, though they begin
with slightly heavier than normal breathing for a few seconds.
Before six months ago this type of experience was rare for me,
but it did happen a few times during moments of VERY high stress.

Type 2, "confusion"--
This one resembles one I had from a few years old into my 20's.
These started again recently (about two months ago?). I get
"caught" visually by nothing in particular and I stop moving. Unlike
with "the limps", I feel that I can move, but I don't (though I may
occasionally take a small step backwards, if standing). It is hard
to move my center of vision very far, and all things visual appear
to be there and in normal proportion, but "smashed" up close to
me, and it is hard to make sense of what I see. I feel as if dizzy,
but I'm not dizzy. I often feel moderate pressure in the area of
my eyes, upper nose, and lower forehead. I also feel unusually
aware of the sound field all around me. These now happen 1-3
times a day, last 3-7 minutes or so and then go, and they sometimes
leave me feeling "unsettled" and sometimes jittering for many hours
afterward.

Type 3, "jitters"--
This one can last for many hours, and appear many days in a row,
then go away for many days. The jittering may be slight (almost
"internal" only), or quite pronounced. Sometimes it is combined
with hyperactivity (rare, except for about three weeks when
coming off Topamax), and it can start on its own, sometimes follow
moderate upset, or it can follow "confusion". Speech is often
somewhat affected.

Type 4, "jerks"--
This one can range from a slight single jerk through moderate
jerks, to very large, overall jerks (with single or with rapid
repetition of the jerks). These can occur in my arms (both or
one, more often the left), or my legs, or body only, or left side
only, or everything at once (symmetrically). I often stop breathing
during these episodes if the jerking is large and repeating. If the
jerks are isolated, the episodes can last a long time, but if they
are intense and repeating rapidly, the episodes are short (generally
less than a minute). I've had very occasional episodes of jerking
over the last 30 years (since about age 30), but now these are
much more common. These, like "jittering", will be around for a
few days (with sometimes several episodes a day), then go away
for a few days, or longer (and they appeared to go away completely
during the three weeks I was on low-dose Topamax). I also have
RLS and PLMS.

Type 5, "muscle-control problems"--
I sometimes find it difficult to control muscles well while doing
simple things like standing, using an exercise machine (Gazelle),
eating, preparing food, shopping, etc. This affects mostly arms,
hands, and legs (though I can walk), though this can also affect
my body (and I sometimes feel the need to intentionally straighten
myself while walking, standing, or sitting). When experiencing this,
it is difficult to pick up or move something with one "clean"
movement, and I tend to repeat movements a few times (with
"jabs" or "wide-approaches") to finish what I am trying to do.
Other body parts sometimes move to "assist" intended movements.
This diminished rapidly while on Topamax, and I experienced little
of this for a while afterwards, but a bit of it has recently returned
(it is relatively rare and slight, though, compared with three months
ago).

Type 6, "speech problems"--
Before six months ago, I had no speech problems at all (though
I would sometimes vocalize during a fever). About six months
ago, I began having some slurring and stuttering ("s", "f", "h", and
"c" sounds at the beginnings of words were particularly difficult),
with common repetition of words to finish a phrase. On Topamax
my speech problems became MUCH more serious (with frequent
babbling of nonsense words, blurting out of nonsense words when
quick responses were intended, having sentences interrupted by
jumbled blurted words, and having great trouble at times beginning
sentences and with pronouncing even very common and simple
words). Since going off Topamax most of these problems have
diminished, but most have remained. The random babbling and
blurting has finally mostly gone away (though I still may babble
nonsense almost continually while showering, especially when
using a brush, or during teeth-brushing), but there are still daily
problems with "clean" speech much of the time, and there is often
an hour or two during which it is extremely difficult to talk at all.
During these I cannot figure out how to say words I know,
especially the first word in a sentence (I know the word, but I can't
figure out how to form it - but I sometimes manage to try various
approaches and forms until I get it out). This has been the most
troublesome and annoying aspect of all. (Possibly irrelevant, but
from what I can gather I was born left-handed but forced to be
right-handed very early - and I'm now left-eyed, ambidextrous
with eating, and mostly right-handed with most other things.)

Yuh, I know, "nuttier than a fruit cake"...;-) Heck, sometimes
even I think that - until I'm in my next "episode" and it then seems
all too real, absurd as it is. Suggestions are welcome, and if in
email only, please alter the obvious in the address before sending.
Thanks.