Can POTS Cause Seizure-like Symptoms and Activity?

Understanding Seizure-like Symptoms Not Caused by Epilepsy

Seizures are sudden rush of electrical activity in the brain that cause changes in behavior, movements, emotions, sensations or levels of consciousness. While epilepsy is the most recognized cause of seizures, about 90% of first time seizures are not actually due to underlying epilepsy.

Seizure vs Epilepsy

The difference between seizures and epilepsy comes down to recurrence. Epilepsy is defined as having two or more unprovoked seizures. This suggests an underlying neurological condition causing chronic, recurring seizures.

Meanwhile, a one-time or acute seizure may never happen again. These seizure-like episodes can result from an external trigger like drug use or trauma. They do not necessarily indicate an ongoing seizure disorder or epilepsy.

Common Causes of Seizures Without Epilepsy

There are many potential causes of non-epileptic seizures. Some of the most common include:

• Drug or alcohol use
• Medication side effects
• Low blood sugar (hypoglycemia)
• Electrolyte imbalances
• Kidney or liver failure
• High fever (febrile seizure)
• Stroke (cerebrovascular event)
• Heart problems causing low oxygen
• Head injury or trauma
• Infections like meningitis or encephalitis
• Heat exhaustion or heat stroke

In many cases, eliminating the trigger can stop future seizure activity without epilepsy medications. However, some underlying health issues may require additional treatment.

POTS Can Also Cause Seizure-like Symptoms

Along with the common causes above, researchers have linked seizure-like activity to disorders involving orthostatic intolerance and dysautonomia like postural orthostatic tachycardia syndrome (POTS).

POTS is a blood circulation disorder that impacts the autonomic nervous system and can cause significant changes in blood pressure and heart rate in response to postural changes. This means when moving from lying or sitting to standing, blood has difficulty circulating properly, triggering rapid heart rate spikes and other symptoms.

The Link Between POTS and Seizure-like Symptoms

Studies show anywhere from 13-67% of those with POTS and orthostatic intolerance also experience non-epileptic seizures. These seizure-like episodes tend to occur most with prolonged standing or other orthostatic stress triggers common with POTS flare ups.

Researchers believe that the rapid changes in heart rate, blood flow, circulation, and blood oxygen saturation associated with POTS may disrupt normal brain functioning enough to cause seizure-like signs. POTS can reduce oxygen and other nutrients getting to the brain.

Factors like chronic stress and anxiety commonly accompanying POTS may also play a role. This could explain why anti-anxiety medications help control seizures for some POTS patients.

Characteristics of POTS-Related Seizure Symptoms

Seizure-like activity caused specifically by POTS or orthostatic intolerance tends to have the following characteristics:

• Occurs in upright positions rather than lying down
• More common with prolonged standing
• Activity seems responsive to positional changes
• Minimal or no confusion after the seizure-like event
• No involuntary bladder or bowel movement

This pattern contrasts somewhat with classic epileptic seizure presentation. However, symptoms can still vary or overlap significantly in some cases.

Common POTS Seizure-Like Symptoms

The specific signs experienced with non-epileptic seizure activity linked to POTS usually fall in a few categories:

• Loss of muscle control - Weakness, trouble supporting oneself, collapsing
• Impaired awareness - Becoming unresponsive but still awake
• Involuntary movements - Muscle twitching, shaking, thrashing, jerking
• Sensory distortions - Numbness, tingling, flashing lights, muffled hearing

These symptoms typically last anywhere from several seconds to 2-3 minutes on average. Longer, more intense seizure-like activity may signal another cause like epilepsy.

Getting an Accurate Diagnosis

Given the diversity of potential causes behind non-epileptic seizure events, getting the right diagnosis is crucial but can prove challenging. Doctors may mistake POTS-related seizures for epilepsy, leading to unnecessary medications with significant side effects.

Key steps for accurate diagnosis include:

• Comprehensive physical exam checking vital signs lying down and standing
• Detailed history gathering all symptoms experiences and potential triggers
• Autonomic nervous testing like QSART or tilt table test
• Lab work checking blood sugar, electrolytes, kidney and liver enzymes
• EEG while lying down and standing to check brain wave activity
• MRI, CT or functional MRI to visualize brain structure and activity

Ongoing symptom journaling and tracking potential correlations with dietary changes, activity, or medications can also help identify POTS related non-epileptic seizure patterns specifically.

Treating POTS Related Seizure-Like Symptoms

The first line approach for managing presumed POTS related seizure-like activity involves preventing episodes by strictly managing all POTS symptoms. Key strategies include:

• Aggressive increased salt and fluid intake
• Compression garments to improve circulation
• Medications to regulate heart rate and blood pressure
• Exercise training to grow veins and improve stamina
• Stress reduction techniques
• Pacing all activity and avoiding over-exertion
• positional changes slowly and deliberately

It is also vital to closely control any contributing factors like managing diabetes, eliminating triggers like caffeine or alcohol, and adjusting any medications linked to low blood sugar or electrolytes.

If non-epileptic seizures related to POTS continue occurring despite strict symptom control, anti-seizure or anti-anxiety medications may provide additional protection. This should coincide with ongoing evaluation for any other underlying or alternative causes.

POTS Related Seizure-like Events Summary

Rapid changes in oxygenation, blood pressure, circulation, and vital nutrients getting to the brain can sometimes cause seizure-like activity for those with POTS or orthostatic intolerance. Strict POTS symptom management provides the best protection against these non-epileptic seizures.

Accurate diagnosis and tracking seizure triggers proves essential as well to distinguish POTS episodes from epilepsy or other underlying disorders. Addressing the root causes then allows treatment to prevent further seizure events and associated risks from recurring.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.