24-Year-Old Woman Experiences Sudden Hand and Foot Tremors—Turns Out to Be a Seizure Episode

In the field of neurology, seizure episodes are often misunderstood or misdiagnosed, especially when they occur only once. This case involves a 24-year-old woman who experienced sudden shaking of her limbs and altered consciousness. Although the symptoms resembled those of epilepsy, further investigation revealed a single seizure episode likely triggered by stress and anxiety. Below is a detailed overview of her condition, treatment, and recovery process.

Understanding Seizure Episodes vs. Epilepsy

Seizures are the result of abnormal electrical activity in the brain. A single seizure does not necessarily mean a person has epilepsy, which is typically diagnosed after multiple unprovoked seizures. In this case, the patient had only one episode and showed no long-term neurological issues, leading to a diagnosis of an isolated seizure rather than chronic epilepsy.

Patient Overview

Age: 24
Gender: Female
Hospital: The Second Affiliated Hospital of Harbin Medical University
Visit Date: January 2022
Diagnosis: Seizure Episode

Treatment Plan and Medication

The patient was admitted for observation and treated with a combination of medications to address both neurological and psychological factors. Her treatment plan included:

Xingnaojing Injection: For brain protection and calming effects
Glycerol Fructose Injection: To reduce intracranial pressure
Bailemian Capsules: To improve sleep quality
Flupentixol-Melitracen Tablets: To manage anxiety and mood

She was hospitalized for six days and scheduled for a one-month outpatient follow-up to monitor her recovery and prevent recurrence.

Initial Consultation and Symptoms

One day before admission, the patient experienced a sudden seizure characterized by limb shaking, upward eye rolling, and vocalization. There was no foaming at the mouth, tongue biting, or urinary incontinence. The episode lasted about two minutes, followed by confusion for approximately 20 minutes. Although she regained full consciousness, she experienced headaches and dizziness but no motor weakness or numbness.

Her family, concerned about the incident, brought her to the hospital. Upon evaluation, it was discovered she had been under significant academic stress, had poor sleep quality, and was emotionally tense. A CT scan of the head showed no abnormalities, leading to a preliminary diagnosis of a single seizure episode.

Medical Evaluation and Diagnostic Findings

During her hospital stay, the patient was alert and coherent, with stable vital signs. Neurological exams showed no signs of meningismus or pathological reflexes. MRI and DWI scans revealed no structural brain abnormalities or acute ischemic changes. An EEG also showed normal brain activity.

However, psychological evaluation using the Hamilton Anxiety Scale indicated moderate anxiety with a score of 16. The medical team concluded that emotional stress and lack of sleep were likely contributing factors to the seizure episode.

Positive Treatment Outcomes

After six days of treatment, the patient's anxiety levels decreased, and her sleep improved to about 5–6 hours per night. She did not experience any further episodes of limb shaking during her hospital stay. She was discharged with instructions on lifestyle modifications and emotional regulation techniques.

The patient was advised to maintain a balanced routine, practice stress-reduction techniques, and ensure adequate rest. She was also told to seek immediate medical attention if another seizure occurred.

Post-Discharge Care and Precautions

Although the patient recovered well, it is important to understand the precautions for preventing future episodes:

Avoid physical and emotional stressors
Ensure adequate sleep and rest
Avoid stimulants like caffeine, alcohol, and spicy foods
Monitor for atypical symptoms such as brief loss of awareness or sudden falls

If another seizure occurs within six months, a follow-up video EEG and lumbar puncture may be necessary to determine the underlying cause and guide further treatment.

Reflections on the Case

This case highlights how stress, lack of sleep, and emotional strain can trigger a seizure in otherwise healthy individuals. While conditions like fever, electrolyte imbalance, drug overdose, or alcohol withdrawal can also cause isolated seizures, they often do not require long-term antiepileptic therapy if no recurrence occurs.

Mental well-being plays a crucial role in overall health. Encouraging open communication, maintaining a balanced lifestyle, and seeking timely medical care are essential for managing and preventing seizure episodes.