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The Physician
The Physician, Doctor
Category: Neurology
Satisfied Customers: 1122
Experience:  Versatile emergency Physician, 20 years experience as a Physician
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Hi, i dont know when i started doing it may be about 6 months

Customer Question

Hi, i don't know when i started doing it may be about 6 months or so or even longer but over the past few months it's got slightly worse, i make slight head movements and back/ shoulder movements that i don't need to make but i'm aware i'm doing it and can control it for a while but feel like i need to make these movements if you know what i mean, i had one full blown seizure when i was 12 and then was diagnosed with a benign brain tumor witch was removed successfully, i'm now 23 and haven't had a fit since, after i was then having MRI scans and check-ups with my neurologist every 6 months then they upped it to about every 9 months to a year, all the results from the scans came back fine and my neurologist was happy with me but they decided to stop my scans about 3-5 years ago, my last appointment with my neurologist though was a few months ago and he did a physical exam like checking my eyes, muscle strength, follow the finger test and it was normal and he was happy with me but i'm just a bit concerned why i'm doing these occasional odd movements so wanted a bit of feed back on it from a neurologist, i'm on lamotrigine 200 mg in the morning and at night, i was told i could come off my medication a few years ago if i wished so but i just decided to stay on it, i've also got a history of some anxiety but i haven't got anxious for a couple of years now, i'm on antidepressants as well, 20 mg of citalopram in the morning and 15 mg of mirtazapine at night.
Submitted: 3 years ago.
Category: Neurology
Expert:  Shantal-Mod replied 3 years ago.

I'm Shantal and I'm a moderator for this topic.

We have been working with the Experts to try to help you with your question. Sometimes it may take a bit of time to find the right fit.

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Customer: replied 3 years ago.

Hi, ok i will continue waiting although it has to be a neurologist i want to talk to though,


Expert:  The Physician replied 3 years ago.

Hello my name is***** the Physician Welcome to I have reviewed your history, and what you describe is typical dystonia. It is a known side effect of Citalopram and Mirtazapine. The fact that you take both of them, heightens the risk of this known side effect. However, dystonia is also seen in some persons with anxiety, who are not taking any of these medications. The neurological relevance would be determined by a thorough neurological examination, which you said had been done already and was normal. So my advise would be to ask your physician to prescribe an alternative mild medication for your anxiety disorder, so you can be weaned of those two medications. especially as you had been asked to discontinue them previously. I believe these measures will control, the dystonia. If it does not after a few weeks. then you may need another MRI and nerve conduction studies.

Do not fail to get back to me if you need any clarifications


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Customer: replied 3 years ago.

Hi Dr Obinna sorry for the late reply i haven't been able to get access the internet, oh right i see thanks for letting me know what it actually is, sometimes i do it with my back as well i move my back and it tenses a bit but it's mainly just neck and head movements, i had the EEG done about three ago and my last MRI scan about 4 or 5 years ago i cant remember exactly, ye i saw my neurologist 4 months ago and he did a neurological examination and it was fine but i didn't mention to him about these movements because i wasn't noticing them "as much" at the time, also i forgot to mention as well sometimes i've been taking all my medicines at varied times so not the exact same time all the time and i've been going out jogging a bit lately so could this have an effect? Sorry about the misunderstanding i meant i was given the option by my neurologist a few years ago if i wanted to stay on my epilepsy medication Lamatringine or weened off it witch i've been on since i was 12, it was my GP who was the one who prescribed me the two antidepressents and i've been on them as a combination for over two years.


Expert:  The Physician replied 3 years ago.
The pathway in the brain that these medications work has a complex network and off-shoots that I may call 'collaterals'
Just imagine it inhibiting a substance which is inhibitory (reduced flow of current) on one pathway in the brain but the same substance is excitatory on another pathway responsible for maintaining the relaxed tone of muscles.
The development of these chemicals by modern science are highly selective, but there is a limit beyond the control of scientists. Hence the fall out is the occasional side effect with some of these medicines.
So, just like I advised earlier, we work from the known to the unknown.
Your doctor must review those medications, if there is still NEED for you to take them, then he may have to prescribe, medication that can reduce the dystonia.
The good news is that the same medications used to reduce the dystonia, may help your anxiety as well.
Secondly, pursue getting another set of MRI/EEG just to make sure there are no other causes.
Finally, do not allow fear to keep you perpetually anxious, anxiety is NOT your friend.
Do what is necessary, if the results are negative THEY ARE. Don't keep worrying

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