Why couldn't I move?
June 22, 2010 5:02 PM   Subscribe

YANMD but what on earth happened to me last night? Why couldn't I move?

I'd had a mild headache for the last few hours, so I was taking it easy and reading on the couch. Suddenly I felt restless and got up to go outside and water the garden. Outside, I realized that there was something wrong with my vision--the plants seemed to fade in and out of blurriness on the left side of my vision. This just happened for second or two. When I went back inside, I developed a sudden -dreamy- feeling, then my head started to slowly fall. This was followed by my entire body slumping slowly to the ground. I remained motionless in this position for a minute or two, fully conscious, trying desperately to move, but I felt entirely paralyzed. I couldn't even blink.

My boyfriend noticed this and said, "Sunnichka? Sunnichka? Are you okay?"

The strange thing is that I was able to just barely mumble to him, "Im-ok" and then "hang-on." But more than that, I was absolutely incapable of.

Eventually, I succeeded in moving the tips of my fingers, and then it felt like the ability to move quickly washed through the rest of my body, and I righted myself.

Afterwards, I was very, very tired and wanted to go to sleep immediately.

I'm already in the process of seeing doctors because I am having strange visual problems. (Seeing afterimages all the time, motion after-effects whenever I've been walking around for a while, strange peripheral field disturbances. . . .for instance, I can't drive anymore because I see the cars behind me jerking into my lane (though this is not actually happening.)

My neurologist is baffled and is sending me to a neuro-opthalmologist who also says he has no clue, but who has scheduled a visual-field test for me next month. But what on earth is THIS new development? It doesn't seem like an atonic seizure, because my understanding is that those happen so abruptly. And why on earth would I still have very slight control over my voice?

Am I going insane? What could be wrong with me? How do I even tell my doctor this? Won't he just think I'm crazy? Do you have any ideas about what could have happened to me, Metafilter?
posted by sunnichka to Health & Fitness (37 answers total) 26 users marked this as a favorite
No, he won't think you're crazy. Yes, it does sound very much like you had a seizure. Call your doctor as soon as possible. If it was a seizure, he/she needs to know, and if it wasn't, it could potentially be something more serious.
posted by hat at 5:15 PM on June 22, 2010

Get off the computer and go to the emergency room. It might have been a stroke or a seizure, and strokes often come in series. Tell them what happened. Don't wait to make an appointment.
posted by Jairus at 5:16 PM on June 22, 2010

I have no idea what happened to you, but you DEFINITELY need to tell your doctor about this incident.
posted by littlesq at 5:17 PM on June 22, 2010

From the AHA:

If you notice one or more of these signs, don't wait. Stroke is a medical emergency. Call 9-1-1 or your emergency medical services. Get to a hospital right away!

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

Not all the warning signs occur in every stroke. Don't ignore signs of stroke, even if they go away!

Until it has been ruled out, you're in a medical emergency. Right now. Go.
posted by Jairus at 5:19 PM on June 22, 2010

Best answer: Consider the variations of migraine, some of which might fit your symptoms. The aura, in particular might explain your visual disturbances.

In particular, check out hemiplegic migraine.

Symptoms may include the following:

- Episodes of prolonged aura (up to several days or weeks)
- Hemiplegia (paralysis on one side of the body)
- Fever
- Meningismus (symptoms of meningitis without the actual illness and accompanying inflammation)
- Impaired consciousness ranging from confusion to profound coma
- Headache, which may begin before the hemiplegia or be absent
- Ataxia (defective muscle coordination)
- The onset of the hemiplegia may be sudden and simulate a stroke.¹
- Nausea and/or vomiting
- Phonophobia and/or photophobia

Note that there may or may not be a headache with this type of migraine. My BIL has had several of these. The first time, they thought he was having a stroke & he spent a night in the ER. Because he had no headache, nobody considered migraine. It too a while to get a diagnosis b/c this is rather rare.
posted by caroljean63 at 5:19 PM on June 22, 2010 [1 favorite]

Best answer: The sensations you describe while you were on the floor reminded me a lot of how I feel when I'm having an episode of sleep paralysis. Sometimes I can speak (sort of, a little bit, weakly) but I can't voluntarily move my body at all. Have you ever had any of the symptoms/problems that go along with narcolepsy or related sleep disorders?

Here's a description of cataplexy from wikipedia
posted by trunk muffins at 5:20 PM on June 22, 2010 [2 favorites]

Have you had an MRI based on your previous symptoms? Going from something minor (partial seizures, small bleed, mini-strokes) to something major (tonic-clonic seizures, hemorrhage, big stroke) is pretty common.
posted by supercres at 5:21 PM on June 22, 2010

Best answer: I have absolutely no idea what caused this, but one comment of yours concerned me:

How do I even tell my doctor this? Won't he just think I'm crazy?

You tell your doctor this by telling him exactly what happened, not omitting a single detail. You will tell him about everything you ate and drank that day, what exercise you got, whether you felt dehydrated, if you have a cold, all drugs (legal and otherwise) that you took.

Doctors like to know this stuff. He won't think you are crazy unless you have the world's worst doctor (and if you do, I'm sure you like to find that out, wouldn't you?)

Oh, NEXT TIME, GO TO THE FREAKING ER. I tend to be a pretty stoic dude and avoid doctors more than I should, but temporary paralysis is way beyond something I'd just shrug off. In fact, if your medical group has an after hours line, give them a call now. That's what they live for.
posted by It's Never Lurgi at 5:24 PM on June 22, 2010

Something similar happened to a 31 year old woman I know and it was a stroke. HOSPITAL.
posted by pseudostrabismus at 5:28 PM on June 22, 2010

Sounds like a petit mal seizure or a stroke. See your doctor, please!
posted by InsanePenguin at 6:01 PM on June 22, 2010

Response by poster: Hi everybody, thank you for all the advice so far. (and so quickly!) To clarify, I'm a 24 year old female, and I've recently had a normal MRI. Since I feel just fine today (after a long sleep), I'm reluctant to check myself into the E.R.--but you're certainly convincing me to make a special call to my doctor. As I've continued to develop new symptoms this summer, I've been emailing my neurologist about it, but he keeps saying that he wants to wait for the results of my visual field test (July). Perhaps I will call my general practitioner (who referred me to the neurologist) instead, and see if he is newly concerned.
posted by sunnichka at 6:06 PM on June 22, 2010

Yeah, that sounds like a stroke. Please go to the hospital.
posted by emeiji at 6:36 PM on June 22, 2010

I'm willing to bet that your neurologist will probably want to see you sooner than July if you call and tell him about this. At the very least, please do call your GP if you're not willing to go to the hospital. If you're afraid to tell your doctor, just blurt it out; nobody is going to think you're insane.
posted by corey flood at 6:47 PM on June 22, 2010

Best answer: Lack of control of your body, slurred or difficult speech? You need to get yourself to the ER. Those are symptoms of stroke, or TIA (aka transient ischemic attack, or mini-stroke.) They could also be other things (migraine, plus others) but you DO NOT FUCK WITH YOUR BRAIN.

A clean MRI means nothing. I will tell you my story, which ends up with a happy ending, but at the time it was down right freaking me out. Me, 28 year old female, with random weakness in my right arm and leg. Meh, no big deal, right? It never lasted more than 10 minutes. One neuro said they were migraines. Finally I went to the ER, because I finally had had enough.

My first MRI came back clean. Finally, the THIRD radiologist thought he saw something. Long story short - I have a giant blood clot in my brain, on the left side. Turns out I've had at least 6 TIAs, and dozens of "episodes." Basically, I was a full blown stroke waiting to happen (a stroke that would have most likely, destroyed my speech and control of the right side of my body). The brain is a wonderful thing and in my case righted itself (new vessels have actually grown around the blockage), but damn those were 6 scary months while they did every test in the book and lectured me on when to get my ass to the ER (basically, if anything ever happened again). And it is with this wisdom I'll repeat the moral of my story:

posted by cgg at 6:48 PM on June 22, 2010 [7 favorites]

Sounds like what I experience in Pre-syncope. Frequently. Unless I'm having a full syncope that time, in which case there's also unconsciousness.

FWIW, I have bizarre visual issues possibly associated with orthostatic hypertension ("POTS"), but am going to a neuro-ophthalmologist next month. Feel free to contact me if you want.
posted by galadriel at 7:04 PM on June 22, 2010

I never say this, I'm always the one being the voice of reason, but this is definitely an ER-worthy event. Now, so much later, perhaps not. You are clearly unwilling to go to the ER, and since you're the one who's sick, that's your call.

However, I want to add that I'm annoyed at your neurologist. It sounds like he's brushing you off. Perhaps because you email him, instead of scheduling appointments as most people would do. Perhaps you are behaving timidly or downplaying the severity of your symptoms, because you worry that he will think you are crazy.

I think you should call your GP and ask for another referral/second opinion. Explain that your symptoms keep getting worse, but your neurologist isn't even going to discuss anything with you until he gets some test a MONTH FROM NOW.

I'm sure the neurologist is great, but I am startled and alarmed by his indifference.
posted by ErikaB at 7:12 PM on June 22, 2010

This sounds to me like a TIA. Please go to the ER.

Whatever reason is at the root of your reluctance is not worth the potential risk of permanent brain damage or even death.
posted by coolgeek at 7:27 PM on June 22, 2010

Best answer: It sounds close enough to a stroke that I would advise you to check yourself into the ER, even if you're feeling better now.

Trust me, I know it seems weird. I fainted in the shower on Sunday and felt fine Monday but when I called to make an appointment just to get it checked out they asked that I go to the ER, so I did. I was reluctant because it didn't seem like a huge deal -- it was probably just hypotension from the heat -- but everyone else waiting at the ER was also there for something that wasn't obviously immediately killing them. You don't mess around with neurological things, fainting, etc, for good reason. If it was a stroke, which is possible, you need to go get it checked out ASAP. If it wasn't a stroke, you still need to know what it was. No one's going to get angry at you for showing up if it doesn't end up being serious.

I think especially given all the other symptoms you're already investigating, it is important to go to the ER. And I think your doctor will think you're anything but crazy. Even if this was your first unusual neurological issue he wouldn't think you're crazy.

Also, bonus reason to go: the ER doctor I got is way more competent than my GP -- my GP is often pretty rushed and dismissive, since he, like so many other GPs, is overworked. And even if that weren't the case, it's another perspective regardless. The ER doctor might find something or figure something out that your other doctors haven't.

It cost as much as a visit to my GP ($15) even with the EKG and all the bloodwork they ran, but I'm insured so I can't promise you anything there, depending on your situation. Generally speaking I assumed it would be expensive, though, and I was wrong.

I worried it would be some scenario where I'm some special fragile snowflake hogging resources for something trivial, but it wasn't like that at all and no one seemed at all surprised that I had showed up for something like fainting in the shower; they all sincerely thought it was the right thing to do coming to the ER. The perception I had was that they appreciate people coming in to be on the safe side, rather than waiting until something was obviously serious. The latter is more costly for everyone, too.

The ER exists in part for the sort of scenario you've been through; not just immediate life-threatening emergencies, but for scenarios where something potentially serious has happened and you need to be able to see a doctor as soon as possible because something might happen soon. In my case, they suggested in the ER partly because I wouldn't be able to see my doctor until Thursday and they felt that was too long to wait if I had something neurological going on. So don't feel like you're imposing or you're not allowed to show up just because you feel okay now. It would be irresponsible not to go.

Anyway, I can't tell you what exactly is going on, but I'm sorry you're having to deal with all this scary stuff. Stay strong and I wish you the best!
posted by Nattie at 7:33 PM on June 22, 2010 [3 favorites]

The sleepy bit sounds post-ictal-- which happens after a seizure, and, sometimes, after a migraine. You need to be worked up again, and soon, and the ER would be a good route for that.
posted by fairytale of los angeles at 7:49 PM on June 22, 2010 [1 favorite]


I hope you're at the ER. I know a night in the ER is no fun at all, but you owe it to yourself and your boyfriend to get this checked out immediately.
posted by lukemeister at 8:53 PM on June 22, 2010

Response by poster: Okay, I'm convinced. I'm going. Updates tomorrow.
posted by sunnichka at 9:18 PM on June 22, 2010 [7 favorites]

Please do update, and I hope everything turns out okay.
posted by insectosaurus at 2:34 AM on June 23, 2010

Am an ER doctor. Look forward to your update and agree with the above advice. I often feel that people do not make enough use of primary care doctors or urgent care settings, but this is not the time for that. I'd say 90% of the patients I see daily in the ER do not have as serious a complaint as you have. Hope you got the full-on checkout. I admit the first thing that came to my mind was an atonic seizure, but there are other serious possibilities as well. Presyncope is unlikely, that just means feeling lightheaded/faint, and what you had was clearly more complicated than that.

I disagree with the comment above from cgg that a clean MRI means nothing - it means a lot, actually, because it tells you about a whole lot of problems that you DON'T have. However, a clean MRI before this doesn't tell you what caused this episode, and as the commenter pointed out, there are some vascular problems that require different studies.
posted by treehorn+bunny at 4:29 AM on June 23, 2010 [2 favorites]

Yes, please update. Hope all is well.

And thanks treehorn+bunny - you're obviously right, a clean MRI does mean something; a lot, actually. Bad choice of words on my part. I guess what I was trying to say is that a clean MRI doesn't necessarily mean all clear, or that everything's fine. In my case, I learned the hard way that things don't always or necessarily show up, or can be misinterpreted.
posted by cgg at 8:04 AM on June 23, 2010

I hope everything's OK, sunnichka. Please fill us in when you have a chance.
posted by lukemeister at 10:04 PM on June 23, 2010

OP's boyfriend here:

I just got home from the ER, where we've been since about 1 PM yesterday. It's 1 AM here now, and they decided to admit her to the hospital overnight about an hour ago.

The ER doctors quickly ruled out a stroke, since her episode affected both sides of her body. One doctor arrives, takes some info, then has to leave for incoming trauma case. The head of the trauma center wandered by, actually, took some information, and said it sounded like a psycho-motor seizure. More waiting, etc, the original ER doctor comes back and suggests seizure activity, orders tests.

Over the course of several hours, an EKG, MRI, and EEG were done (as well as a sitting-standing-lying blood pressure test, which had a fancy name that escapes me), and were apparently normal or inconclusive. Finally the neurologist shows up, tests her for anything unusual (at this point I think I've seen the standard 'weird neurology symptoms' test with hammers and vibrating forks about five times).

So, the neurologist suggests epilepsy or migraines, and asks Sunnichka if she wants to be checked into the hospital. That sounded like the better option for getting a diagnosis, so Sunnichka's got a bed for the night over there, and the neurologist has ordered a 4-hour EEG for tomorrow.

She wanted me to thank you all on her behalf, especially since the RN who checked us in agreed that this was definitely an event worthy of a visit to the ER. :)

More info as I get it, likely none until tomorrow.
posted by edguardo at 10:19 PM on June 23, 2010 [2 favorites]

Thanks for the update, edguardo. All the best to both of you from Team MeFi!
posted by lukemeister at 10:47 PM on June 23, 2010 [1 favorite]

Latest text from Sunnichka from inside the hospital (I'm leaving to visit as soon as I update this):

"Ion channel abnormality leads to familial hemiplegic migraine and a sleep disorder where REM paralysis intrudes into daytime. This also explains my night babbling, sleepiness, and everything else. Totally treatable!"

That's the diagnosis the neurology team gave her, and they're apparently waiting on some blood test results, and will be starting her on some migraine medication.

Oh, and the "night babbling" refers to Sunnichka's adorable and unsettling habit of saying batshit insane things right as she goes to sleep. Such as "It's okay guys. I got this one. I'm a bear." :D

Working theory is that S. goes immediately into REM sleep, instead of entering REM later in the sleep cycle, accounting for ... well, the talking nonsense for a half hour or so. :)
posted by edguardo at 12:32 PM on June 24, 2010 [8 favorites]

Woo hoo! Sounds like a best-case scenario.
posted by lukemeister at 12:42 PM on June 24, 2010

Presyncope is unlikely, that just means feeling lightheaded/faint

I respect that you're a doctor, but in all seriousness, pre-syncope and syncope can be a lot more complicated than light-headedness. I do lose ability to move or talk when I experience either, during and for a while after, and afterward I am exhausted and wrung out (plus massive, massive, can't-see-straight headaches). Others I know with the same condition have similar experiences. Blood pressure fluctuations can be extremely nasty.

I'm glad to see the OP got checked out and got a solid answer! And it even answers some things she wasn't asking; awesome.
posted by galadriel at 1:58 PM on June 24, 2010

Thanks for the updates. It's great to hear that things are looking good.
posted by alms at 6:25 PM on June 24, 2010

Response by poster: Hi Everybody,

I'm still admitted to the hospital, finishing up my 4-hour EEG. I'm so glad I asked you all for advice. I'm so glad I listened to you.

When I walked into the ER and wrote down "temporary paralysis" as my reason for coming in, the freak-out was immediate. The guy at triage swept me right in--I never even entered the waiting room--and then the nurse, worried about the possibility of stroke, immediately sent me into the Level 1 Trauma Room. An alarm went off through the ER and all the nurses and doctors dropped what they were doing and ran in. The head resident started repeating, "Where's the paralysis? Where are you paralyzed?"

At least twenty people were staring at me, alertly, waiting for action. "Oh my god," I said involuntarily. "I'm fine right now."

Everyone relaxed, laughed as they realized my paralysis had already resolved and that they'd completely terrified me, and the head resident sent me to a room to be examined more leisurely.

But it was somewhere between when the alarm went off, and the entire ER staff showed up to tend me, that I finally believed you all.

And when they admitted me to the hospital, then I REALLY believed you all. :)

After about a billion tests, I don't appear to have any blood clots or bleeds or tumors or brain damage. My brain ventricles are "overly prominent," and I do have some brain shrinkage that is abnormal for my age. But I've got a team of neurologists who have assured me that they won't discharge me until they are sure they know what's wrong.

(Hang on! The Futurama premiere is starting, and this hospital room has a TV with cable!)
posted by sunnichka at 7:01 PM on June 24, 2010 [1 favorite]

Response by poster: (Futurama was as funny as ever!)

I'm spending the night here in the hospital again and everybody's taking good care of me. I'm putting up a picture (covered in electrode goo!) on my metafilter profile so you can see I'm okay :)

I'll let you know when I have a firm diagnosis.

Thanks again for everything,
posted by sunnichka at 8:46 PM on June 24, 2010 [2 favorites]

Thanks for the update. Glad you're getting good care!
posted by Linnee at 12:22 AM on June 26, 2010

Response by poster: I'm out of the hospital! I've got a few medications to try out, and I've already ordered my "medical alert" bracelet. Also, having gotten a narcolepsy diagnosis, my boyfriend can never accuse me of being lazy again. (ha!)

One of my neurologists is still wavering that this might be epilepsy, and my insurance won't pay for the sleep study necessary to diagnose narcolepsy/cataplexy, so my journey to a diagnosis is not yet over.

But I'm in much better shape now than I would have been without that hospital visit.

Thanks for everything, Metafilter.
posted by sunnichka at 8:49 PM on June 27, 2010 [1 favorite]

Response by poster: Hey, this is just a note to say that none of the diagnoses listed above are firm. I did have that sleep study done, and I ended up getting an epilepsy diagnosis from the sleep doctor. But now I'm in the hospital again for these eye-fluttering, incapacitated-but-still-conscious, slight head-drop episodes that I started having nearly constantly. (Don't worry, they've lessened again.) The doctor doesn't think these episodes are epileptic. He says that if they were, they would show up on the EEG. So now he thinks I have Conversion Disorder.

I can't really argue the diagnosis because I was very upfront with my original neurologist and told him I was raised in a cult. I went ahead and was very frank about it with this neurologist, as well. There's no sense hiding anything. But really--I was never physically abused! I was never sexually abused! And thanks to my wonderful grandparents, I even have a great relationship with my parents today. So even though I'm in a great place in my life now, very healthy, very happy, very excited about my present and future, my doctor comes into my room every morning and says, "Have you let this percolate yet? Is there anything else you're ready to tell me about your past?"

It's pretty humiliating. And depressing because it means they won't try to treat me. And worst of all, my biggest fear has come true: they think I'm crazy!

In January, thanks to Obama's health care reform, I'll be able to go back on my mom's health insurance for a year. With her insurance, I won't have to stay within my university hospital's network. Perhaps I'll seek a second opinion then.

Sorry for an inconclusive AskMe.
posted by sunnichka at 9:23 AM on August 19, 2010 [1 favorite]

Oh, geez. Why *do* so many neurologists think that they have specializations in psychiatry, too? How frustrating.

Perhaps it would help to get a thorough analysis from an *actual* psychiatrist, get them to say, "Hey, she's fine" and make the neurologists move along with genuine diagnosis and treatment.
posted by galadriel at 8:14 PM on August 20, 2010 [2 favorites]

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