"Electrical impulses" in brain.

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"Electrical impulses" in brain.

Postby juliespoohbear » Sun Jun 24, 2012 11:43 am

This is my first post and I am hoping someone can tell me that I am not crazy. I was diagnosed with severe obstructive sleep apnea in January 2012 after two sleep studies; one without CPAP and one with. I was referred to a neurologist for this when my internal medicine doctor became concerned about persistent episodes or what I can only describe as "electrical impulses" shooting through my brain. These are followed by dizziness and bouts of nausea. After approximately six weeks of CPAP without improvement and my neurologist (or I should say the PA) dismissing the impulses, I asked for a referral for a second opinion. The second neurologist prescribed an autopap (due to waking up nightly trying to vomit in my mask using the origninally prescribed CPAP) which I will be picking up tomorrow. Dr. "K" did not dismiss the impulses but stated that she feels all current symptoms are directly related to the sleep apnea. Has anyone else experienced these impulses and, if so, please tell me it gets better.
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Re: "Electrical impulses" in brain.

Postby greatunclebill » Sun Jun 24, 2012 12:20 pm

juliespoohbear wrote:This is my first post and I am hoping someone can tell me that I am not crazy. I was diagnosed with severe obstructive sleep apnea in January 2012 after two sleep studies; one without CPAP and one with. I was referred to a neurologist for this when my internal medicine doctor became concerned about persistent episodes or what I can only describe as "electrical impulses" shooting through my brain. These are followed by dizziness and bouts of nausea. After approximately six weeks of CPAP without improvement and my neurologist (or I should say the PA) dismissing the impulses, I asked for a referral for a second opinion. The second neurologist prescribed an autopap (due to waking up nightly trying to vomit in my mask using the origninally prescribed CPAP) which I will be picking up tomorrow. Dr. "K" did not dismiss the impulses but stated that she feels all current symptoms are directly related to the sleep apnea. Has anyone else experienced these impulses and, if so, please tell me it gets better.


i don't have experience with your symptoms, but i do have experience with neurologists. i strongly suggest you deal with an older neurologist that has been around the block many times and seen many things.

i had a young neurologist. every next test was gooing to find the answer. after 5 mri's, a nerve test, a muscle test and a genetic dna test for myotonic dystrophy all of which were negative in respect to the problems except the neck mri. he told me i had spinal stenosis so bad that if i fell down i could become paralyzed. scared the heck out of me. he referred me to his young neurosurgeon friend stating that i needed surgery asap. fortunately the friend didn't take tricare. tricare hooked me up with an older neurosurgeon who in my consult said i didn't need surgery and didn't really have spinal stenosis. that's quite a leap from near emergency surgery to no problem. i then asked my primary care doc for a new neurologist. the new neurologist that was also older stated that my problem whatever it was, was not neurological, that i should stay away from neurologists because i don't need them. true story. at different points in the story i was led to believe i had neuropathy, spinal stenosis and muscular dystrophy and a couple others i forget by the young neurologist.
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Re: "Electrical impulses" in brain.

Postby robysue » Sun Jun 24, 2012 12:48 pm

Some questions:

When you say you are dealing with "about persistent episodes or what I can only describe as 'electrical impulses' shooting through my brain," are you talking about a phenomenon that has shown up in an EEG (either on your sleep study EEG or another EEG)? Or are you trying to describe some kind of physical feeling in your head? If it's the later, why do you describe them as "electrical impulses"? In other words, exactly what is happening? I'm asking because I really don't know how an "electrical impulse shooting through my brain" would feel, but I know all about all kinds of weirdness associated with my migraine headaches.

Do your episodes only happen at night or do they occur when you are awake as well?

You also say these episodes "are followed by dizziness and bouts of nausea." That's a telling symptom. Have you ever been diagnosed with migraines? Contrary to the stereotype of Migraine = Funny Visual Symptoms Followed by Killer Headache on One Side, there's a lot of variation on how migraines can manifest themselves. What I'm wondering is whether or not those "electrical impulses" are your way of describing a migraine aura (which is often, but not always a visual thing). And though it's not common, there are people who experience migraines without the tell-tale headache pain. My mother was one of them. She started getting these really weird visual symptoms that would leave her dizzy and slightly nauseous, but never had a headache. It took some six months of testing to eliminate all kinds of of nasty potential causes before the doctor concluded her problem was "migraines with aura but no headache."
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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Re: "Electrical impulses" in brain.

Postby juliespoohbear » Sun Jun 24, 2012 1:00 pm

I really don't know any other way to describe the feeling and it happens while I am awake. Initially, these episodes were limited to the morning hours but have become an all day thing. I had an MRI without contrast with nothing noted. My second neurologist would like me to try the new autopap machine for six weeks; my next appointment is on August 1st. She stated that if I have not seen a remakable difference in symptoms, we will discuss other tests, possibilities, etc. I am also B12 deficient and give weekly self-injections at this time and have wondered if there is a connection. As for migraines; I have had two full blown migraines in my life...that's all that I know of. Thank you for your feedback! I tell you, it is nice to be able to communicate with others who "get it". And, to great uncle bill, my first neurologist is an older neurologist who has his own sleep study clinic and my second consult was from a middle aged neurologist.
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Re: "Electrical impulses" in brain.

Postby robysue » Sun Jun 24, 2012 1:24 pm

An MRI is not going to pick up "electrical impulses", but an EEG might.

I'd also bring up the possibility of migraines with the neurologist. Migraines are a not well understood neurological problem. The fact that you are B12 deficient may also be tied to migraines, although there seems to be some real disagreement about the connections between B12 and migraines.

You might also want to have your B2 levels tested. Migraines often respond well to megadoses of B2. My own neurologist has me on a vitamin regime to control my chronic (daily) migraines that were primarily showing up in terms of very short lived, but very severe vertigo spells about 18-20 months ago; the vertigo was absolutely painless but it would suddenly strike and for anywhere between 30 seconds and 5 minutes I'd be unable to do much of anything except lean against a wall and wait for it to pass. I'm a professor and when it would happen in class it was sometimes scary enough for my students to sometimes ask me if I was alright. The combo of 400mg B2, 400mg Magnesium, and 7.5mg Deplin has really brought my migraines and the vertigo under control. (Deplin is a prescription "medical food" containing L-methylfolate, which is the active, metabolized form of folate; the neurologist's PA ordered a genetic test that showed that I have a genetic variation on my MTHFR gene which causes my body to not metabolize folate very well.)
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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Re: "Electrical impulses" in brain.

Postby juliespoohbear » Sun Jun 24, 2012 2:58 pm

robysue; you are a wealth of knowledge...really! I am still trying to figure this all out and what it all means I noticed your above results so I pulled my study from 1/22/2012. My RDI is 35.3 AHI is 35.3 AI is 33.1 Still not sure what it all means. My first CPAP: Phillips respironic remstar plus c-flex with humidifier set at 11 and a full face mask. I tried numerous masks. I am picking up an autopap tomorrow with the prescribed levels between 5-12.
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Re: "Electrical impulses" in brain.

Postby robysue » Sun Jun 24, 2012 4:15 pm

juliespoohbear wrote:My RDI is 35.3 AHI is 35.3 AI is 33.1
RDI = Respiratory Disturbance Index
AHI = Apnea/Hypopnea Index
AI = Apnea Index

A respiratory disturbance is a sleep disturbance that is clearly related to respiratory problems in some way. The main types of events that get counted towards the RDI are respiratory effort related arousals (RERAs), hypopneas (Hs), and obstructive apneas (OAs).

An apnea is scored when there is NO AIR moving into or out of your lungs for at least 10 seconds when the EEG says you are asleep. If the belts indicate you were trying to breathe, the event is scored as an OA. The presumption is that your upper airway is completely collapse and no air can get through. If the belts indicate that you were NOT trying to breathe, the event is scored as a central apnea and the presumption is that the problem is that your brain simply (temporarily) forgot to send the signal to the diaphragm to inhale.

Exactly what gets scored as a hypopnea depends on the standard the lab doing the scoring uses. Under Rule 4A, a hypopnea is scored when there is at least a 30% reduction in airflow for at least 10 seconds AND a corresponding O2 desaturation of at least 4%. Such a Rule 4A hypopnea does NOT require an EEG arousal. Under Rule 4B, a hypopnea requires at least a 50% reduction in airflow for at least 10 seconds AND one or both of the following conditions: A EEG arousal OR a corresponding O2 desaturation of at least 3%. Regardless of whether Rule 4A or Rule 4B is used, you can informally think of a hypopnea as when you are attempting to breathe (there is some effort to breathe as measured by the belts) but the air flow is significantly lower than it should be for at least 10 seconds. The usual assumption is that the diminished air flow in a hypopnea is caused by a partial collapse of your upper airway. It's often described as like trying to breathe through a very small straw.

A RERA is something like a "wannabe hypopnea with arousal under Rule 4B." Only the reduction in airflow might not be long enough or deep enough to warrant being scored as a hypopnea under Rule 4B. And a RERA must end with an EEG arousal. It may or may not have a corresponding O2 desat.

The word "Index" means we're looking at the average number of events per hour of sleep as recorded by the EEG. In other words:

AI = (number of apneas recorded while asleep)/(total sleep time as established by the EEG)
AHI = (number of apneas and hypopnes recorded while asleep)/(total sleep time as established by the EEG)
RDI = (number of respiratory events recorded while asleep)/(total sleep time as established by the EEG)

So here are your numbers and what they mean:

AI = 33.1 means that in an average hour of sleep time, you had about 33 apneas occur. In other words, on average you stopped breathing (in the sense of getting air into your lungs) about every 1.8 minutes since 60/33 = 1.8. (In other words, you had a complete cessation of airflow a bit less than every two minutes.)

AHI = 35.3 means that in an average hour of sleep time, you had about 35 apneas and hypopneas occur. From the AI, we know that about 33 of those events are apneas. Hence the other two events are hypopneas. In other words, on average you stopped breathing (in the sense of getting air into your lungs) OR had a serious about every 1.7 minutes.

RDI = 35.3 = AHI means that all of the respiratory disturbances were either OAs or Hs.

Your diagnosis is going to be severe OSA or moderately severe OSA since your AHI > 30. Moderate AHI is defined as
the AHI or the RDI being between 15 and 30.


I am picking up an autopap tomorrow with the prescribed levels between 5-12.
Best of luck in getting some high quality sleep. And make sure that APAP is NOT a Resmed S9 Auto Escape.
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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Re: "Electrical impulses" in brain.

Postby juliespoohbear » Sun Jun 24, 2012 5:15 pm

I think I learned more today than all appointments put together; you should charge a fee! LOL!!! Thanks for clearing some things up and here's hoping for a restful night in the near future for all of us!
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Re: "Electrical impulses" in brain.

Postby dragonflybeach » Sun Jun 24, 2012 9:14 pm

Have you had a change in medications recently? I once had a med that caused a shiver-like feeling in my right arm and traveled up to my head.
Have you ever seen a chiropractor or massage therapist? I'm thinking maybe a tight muscle is causing some nerves to fire a bit more than usual.
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Re: "Electrical impulses" in brain.

Postby juliespoohbear » Mon Jun 25, 2012 7:38 am

Thanks, dragonfly; no changes in medications. I did question the neurologist about a bulging cervical disc and how this could be exacerbating the problems. I was told by the neuro that she feels everything I am experienceing is a direct result of the sleep apnea and she would like to wait until I have been on the auto pap for six weeks before she looks at other possible sources. She stated that the bulging discs need to be addressed but feels it is all seperate.
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Re: "Electrical impulses" in brain.

Postby Todzo » Tue Jul 03, 2012 1:31 pm

juliespoohbear wrote:This is my first post and I am hoping someone can tell me that I am not crazy. I was diagnosed with severe obstructive sleep apnea in January 2012 after two sleep studies; one without CPAP and one with. I was referred to a neurologist for this when my internal medicine doctor became concerned about persistent episodes or what I can only describe as "electrical impulses" shooting through my brain. These are followed by dizziness and bouts of nausea. After approximately six weeks of CPAP without improvement and my neurologist (or I should say the PA) dismissing the impulses, I asked for a referral for a second opinion. The second neurologist prescribed an autopap (due to waking up nightly trying to vomit in my mask using the origninally prescribed CPAP) which I will be picking up tomorrow. Dr. "K" did not dismiss the impulses but stated that she feels all current symptoms are directly related to the sleep apnea. Has anyone else experienced these impulses and, if so, please tell me it gets better.


Greetings and Welcome juliespoohbear!

I have had symptoms similar to yours under two differant circumstances:

1. When becoming resistant to a proscribed Selective Seretonin Reuptake Inhibitor (SSRI) antidepressant.
2. Due to hyperventilation stemming partially from panic stress due to truama from an assault and robbery upon my person in 2005.

I had been taking the SSRI for some five years. I remember shooting feelings, sounds, and a sense of being off balance, indeed, I fell from time to time while this was happening. They moved me to an SNRI which I kind of knew would only last five or so years (what then?!?). I moved to a place where it is much quiter, I am safer, has more sunlight, and cleaner air. I also gave up TV as I felt it tended to stimulate a fight or flight response by it's content -- and -- went off the SNRI. I feel much better now.

My tendency to hyperventilate is now being helped with the aid of a little pulse oximeter on my belt. It is a Model: Concord Sapphire from Concord Health Supply (fifty bucks on Amazon). It is my first "test" of these little one piece "have one on your belt" pulse oximeters and I have found it works pretty well for what I use it for. It helps me find the place where my breathing results in the lowest heart rate holding exercion constant. The oximeter portion is useful in this process. I would consistantly find it reading 99% when I first started this kind of optimal breathing training. It takes considerable effort in quieting one's breathing to bring that number down a percent! You learn to breath out gently, pause for a few seconds, then breath in a bit gently then out gently, and pause again -- then try very gentle and small breaths. I currently find the lowest heart rates when the oximeter is reading about 95% doing quiet things and 96% while climbing hills. For that matter, I love it for "walk up the hill" interval training - so much better than needing to put on a chest strap!!! Love that.

One thing however, when you put in a fresh set of batteries it seems to be less sensitive to reduction in SpO2 for about an hour of use. I overcame that by putting it on my thumb enstead of my finger for that hour. Starting out I think it would be wise to use it for an hour before starting the training.

I have recently lost enough weight so that I am down four noches on my belt (the scale did not make the move and I have not replaced it yet). From my nightly data I see that I have a bit of periodic breathing and sometimes overuse air in an unstable way (you really need to monitor your own CPAP data!!!). I need a pressure reduction. In the mean time I am using the pulse oximeter at night to "get used" to the pressure again at my new weight keeping the air use down so it may remain stable. I find that warm weather and nights make this even harder. Anyway - FWIW

May we all find good sleep!

Todzo
AHI=52 SpO2 Nadir=55% (!!!) Focus & Vigilance problems w/PTSD from Trauma
CPAP since 2003 Respironics REMstar Auto A-flex with EncoreViewer and SleepyHead SW
Pulse oximeter CMS-50-F, night audio recorded via Audacity or Linux “sox”. Zeo.
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Re: "Electrical impulses" in brain.

Postby tracyw » Wed Jul 04, 2012 4:01 pm

juliespoohbear - out of curiosity I am wondering if the "electrical impulses" shooting through your brain showed up during both of your sleep study sessions. The reason I am wondering is because I recently went through three sleep sessions: one without CPAP and two with (first was inconclusive) and on the second and third there was mention of "abnormal brain activity" and with the third they related the brain activity "similar to epilepsy". Been wondering why the abnormalities didn't show up all three times.
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Re: "Electrical impulses" in brain.

Postby juliespoohbear » Sat Jul 07, 2012 8:11 am

Thanks for responding tracyw and Todzo. Tracyw; I don't think there was any abnormal brain activitiy though my internal medicine doctor feels that I am having what she feels are "atypical seizures" as a result of apnea. I have been using the new auto pap machine for a week now and the symptoms have decreased but are still there throughout the day. Did you/do you experience any of my symptoms? Todzo; thank you for sharing and let me say to you that I am sorry for what you have experienced! Also, congratulations on your weight loss...whoop, whoop! I can thankfully say that my circumstances are not the same. I return to my second opinion/neurologist on August 1st and I am so hoping that I will be experiencing a remarkable improvement in symptoms by that time! With the new autopap I am able to see the air pressure required which is two points lower than the original CPAP was set at. The autopap is set for a range of 5-12; my old one was set at 11. The data thus far indicates that the least amount of air pressure is around 6.5 with maximum at 9.6. I had my first full nights sleep last night sleeping from about 10:45-6:30...I wanted to jump up and down and celebrate when I rolled over and looked at the clock!
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Re: "Electrical impulses" in brain.

Postby Todzo » Sat Jul 07, 2012 4:11 pm

juliespoohbear wrote:Thanks for responding tracyw and Todzo. Tracyw; I don't think there was any abnormal brain activitiy though my internal medicine doctor feels that I am having what she feels are "atypical seizures" as a result of apnea. I have been using the new auto pap machine for a week now and the symptoms have decreased but are still there throughout the day. Did you/do you experience any of my symptoms? Todzo; thank you for sharing and let me say to you that I am sorry for what you have experienced! Also, congratulations on your weight loss...whoop, whoop! I can thankfully say that my circumstances are not the same. I return to my second opinion/neurologist on August 1st and I am so hoping that I will be experiencing a remarkable improvement in symptoms by that time! With the new autopap I am able to see the air pressure required which is two points lower than the original CPAP was set at. The autopap is set for a range of 5-12; my old one was set at 11. The data thus far indicates that the least amount of air pressure is around 6.5 with maximum at 9.6. I had my first full nights sleep last night sleeping from about 10:45-6:30...I wanted to jump up and down and celebrate when I rolled over and looked at the clock!


Hi juliespoohbear!

A full night of sleep - very good to hear. Whoop, whoop indeed for that!!

I have come to believe that part of sleep apnea is apneas and hypopnieas and half is breathing instability. I think our lifestyle (work process, diet, lack of exercise, violent media intake, etc..) tends us toward breathing more than we should often - hence my response with a pulse oximeter. One thing that I think all would agree is helpful is the interval training I mentioned. I think it is very good for breathing stability and weight loss. I highly do recommend it!

Your breathing reflexes are getting used to the Auto-PAP that you use and so your success will likely continue and deepen. However, as your body heals that response is also likely to change. Life indeed and the basic nature of our bodies is change. Therefore I strongly recommend that you establish feedback as part of your PAP use. I consider it essential!! You need to be looking at your PAP data with good software to see your AHI (basic apnea) and breathing rate and volumes (breathing stability). Or at least have one of the companies that are set up to do this automatically doing it for you. Otherwise it is likey to be the heart attack, stroke, or diabetic neuropathy that brings you in to see your doctor.

May we continue with good sleep!

Todzo
AHI=52 SpO2 Nadir=55% (!!!) Focus & Vigilance problems w/PTSD from Trauma
CPAP since 2003 Respironics REMstar Auto A-flex with EncoreViewer and SleepyHead SW
Pulse oximeter CMS-50-F, night audio recorded via Audacity or Linux “sox”. Zeo.
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Re: "Electrical impulses" in brain.

Postby jlady » Sun Jul 15, 2012 8:22 pm

I get those electrical feelings every now and then and it is from the SSRI's. I take Paxil and if the dosage changes for whatever reason that is when I feel it the most, I have heard that is very common for people that take that kind of medication.
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