Dr. Florilyn Joyce Chulsi Bentrez
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Some symptoms have been bothering me for years. They are like ticks or pulses that can occur anywhere in the body, such as in the eyelid. When I was about 20 years old, I would stay up late on the computer and I started to feel like there were rays in my head that closed my left eye. I went to a neurologist at the time, and he told me it was stress and prescribed me some pills. But that went away, I was left with those symptoms, which I notice are more intense when I do not sleep well. But lately, I have been feeling it more.
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
Is it present even when you sleep well? Is your stress level more than usual, interfering with your sleep and mood? Are you worried or depressed? What are your other medical conditions? The first line of treatment is still non-pharmacologic, which means conservative measures such as getting enough sleep, avoiding caffeine, practicing relaxation methods, and engaging in habit reversal therapy (with psychologists). If it fails to work, you might try a tablet Olanzapine 5 mg (antipsychotics) once a day at night. However, it may induce drowsiness. It is also critical for me to know the answers to the preceding questions so that I may adapt the management for you.
I hope this helps.
Thank you and take care.
Regards.
Patient's Query
Hello doctor,
I was just diagnosed with IBS. It was caused by a stressful circumstance at work, and since then I have felt uneasy. I started taking probiotics and vitamin B complex, and the discomfort has gone away, but I have been feeling dizzy while sitting and then rising rapidly, so my mother gave me passion flower tea, which has calmed me. I was fine the first day but had trouble falling asleep the next and my symptoms worsened. I believe my symptoms remain even if I sleep well, but I notice them less, and yes, I have been having difficulties sleeping lately.
Kindly help.
Thank you.
Hello,
Welcome back to icliniq.com.
I would recommend a routine. An apple in the morning will wake you up. A banana and milk before bedtime for tryptophan to help with sleep. If there are no adverse effects, take 1 pregabalin 75 mg (anticonvulsant) at 8 p.m. every day for fourteen days. It also helps with sleep and anxiety.
I hope this helps.
Thank you and take care.
Regards.
Patient's Query
Hello doctor,
It appears to be a psychological problem rather than a physical one in the brain. Because I was also concerned that it may be a brain disorder or anything related, which was making me worried. Before taking Pregabalin, I will try to relax with exercise and other things to see if I can obtain better sleep.
Kindly help.
Thank you.
Hello,
Welcome back to icliniq.com.
Tics is classified as a neurology and psychiatry disorder, thus you can try to train yourself on sleep hygiene. Yoga, meditation, and relaxation can also help.
I hope this helps.
Thank you and take care.
Regards.
Patient's Query
Hello doctor,
I tried to do it myself with sleep hygiene and relaxation. But I am still not able to sleep I have like 3 days sleep, just 1 or 2 hours and I feel super week and I feel my heart is working hard, I have to wait until night-time to sleep and I am a bit anxious. I am trying to contact a doctor in person where I live. Is there anything I can do right now? I have not gotten pregabalin yet.
Kindly help.
Thank you.
Hello,
Welcome back to icliniq.com.
Please try taking tablet.Melatonin (tryptamine) 3mg once a day at 7pm. This does not need prescription. No screen time for 2 hours before sleeping. I suggest you see a doctor soon.
I hope this helps.
Thank you and take care.
Regards.
Patient's Query
Hello doctor
I tried melatonin and it helped with the insomnia but still it came back and also the tics (fascinations are more noticeable), I went to a neurologist and he told me to perform two MRIs (cervical and for brain without contrast). But I am really scared because I was reading the results and they said a lot of negative thing about it, so I would like to hear your opinion on it.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Do you have imbalance or do you fall everytime? Do you have difficulty in swallowing? Do you have weakness when raising your arms? Do you have pain over the nape area and the shoulders? We have to correlate clinically. You said the tics come and go? It means the tics are not steady and progressive? Have you done an EMG (electromyography) yet?
Revert with the answer to assist further.
Thank you and take care.
Regards.
Patient's Query
Hello doctor, No, I have never had any such difficulties before, except sometimes pain just in the nape area, sometimes and I feel pressure. We have to correlate clinically. You said the tics come and go? It means the tics are not steady and progressive? Yes doctor, it looks like they get worse when I do not sleep well or I am stressed or tired. I will get an EMG done this week.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
The MRI findings are not worrisome then. But please take care of your posture and check calcium levels so you can take care of your spine. The EMG is the test to tell if the tics are part of motor neuron disease. Lets hope it turns out negative. Please find time to relax. Have a cup of chamomile tea. Also, are you depressed?
I hope this helps.
Thank you and take care.
Regards.
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