A POTS "seizure" is usually convulsive syncope—a fainting episode caused by lack of oxygen to the brain, rather than epilepsy. It often looks like a sudden collapse followed by stiffening, jerking, or shaking movements, typically occurring right after standing up or during prolonged standing.

Can a POTS episode look like a seizure?

There are several reasons for seizure-like episodes in people with HSD and POTS. These seizures not associated with the typical epileptic neural activity may be called: non- epileptic seizures, psychogenic non-epileptic seizures (PNES), syncopal seizures.

What are the symptoms of POTS seizures?

The symptoms of POTS include but are not limited to lightheadedness (occasionally with fainting), difficulty thinking and concentrating (brain fog), fatigue, intolerance of exercise, headache, blurry vision, palpitations, tremor and nausea.

What does a Severe POTS episode look like?

While everyday POTS symptoms might include lightheadedness, rapid heartbeat when standing, or fatigue, a flare is more intense and disruptive. During a flare, you may experience: Dizziness or near-fainting that's stronger than usual. Racing heart rate even with minimal activity.

What triggers a POTS flare-up?

Causes of postural tachycardia syndrome (PoTS)

Some things can also make your symptoms worse, such as: being in a hot place. standing or sitting upright for long periods of time. eating, especially refined carbohydrates like white bread.

Seizure and Fainting in Autonomic Disorders Presented by David Saperstein, M.D.

What can confirm a seizure?

Electroencephalography (EEG)

Clinicians can find evidence of abnormal electrical activity in the brain and figure out the type or types of seizures a patient is having, as well as the origin(s), by measuring brain waves over minutes to a couple of hours.

What is the rule of 3 for seizures?

The "Rule of 3" for seizures refers to two different concepts: a medical guideline for defining seizure freedom (wait 3 times the longest prior seizure interval) and first-aid steps (Stay, Safe, Side). Medically, the "Rule of Three-To-Six" suggests waiting three times the typical seizure interval to confirm seizure freedom after an intervention, but potentially longer (up to six times) if seizure risk is high, while clinically, the 3 S's (Stay, Safe, Side) guide first aid: Stay with the person, ensure they are Safe, and turn them on their Side for breathing.
 

What does an autonomic seizure feel like?

Focal autonomic seizure with epigastric sensation (upper abdominal discomfort, emptiness, tightness, churning, hunger - the feeling may rise up to the chest or throat) or with nausea / vomiting (or other gastrointestinal phenomena) - seizures with these features typically arise in the mesial temporal lobe.

What can be mistaken for POTS?

POTS (Postural Orthostatic Tachycardia Syndrome) is often mistaken for conditions with similar symptoms like anxiety, Chronic Fatigue Syndrome (ME/CFS), fibromyalgia, dehydration, thyroid issues, or anemia, leading to misdiagnosis as psychiatric disorders or other chronic illnesses due to overlapping symptoms like rapid heart rate, dizziness, fatigue, and brain fog. Other mimics include Ehlers-Danlos Syndrome (EDS), autimmune disorders, dysautonomia, and even medications, requiring careful evaluation to differentiate its autonomic dysfunction from these other conditions. 

How common are seizures with POTS?

This would be unusual. However, a number of patients with POTS have episodes that look like seizures, but are complications of not getting sufficient blood to the brain due to POTS. It is hard to give a general answer to this as it depends on many factors.

What does a stress seizure look like?

It may look like you're having symptoms similar to tonic-clonic seizures, with full-body shaking that's common in epilepsy. Or you may have twitching or jerking in your limbs. Events may also present as absence seizures (a brief lapse in awareness) or drop attacks.

What are lesser known symptoms of POTS?

What are Some Lesser-Known Symptoms Which may go Unnoticed? With POTS being associated with so many different symptoms, some common symptoms which go unnoticed include a lack of sleep, gut problems (which sometimes get misdiagnosed as IBS), tiredness and bladder problems.

What does the ER do for seizures?

The ER stops active seizures with fast-acting IV benzodiazepines (like lorazepam, diazepam) and provides oxygen, stabilizes the patient, and investigates the cause with tests like EEG and brain scans (CT/MRI) to rule out emergencies like stroke or infection. Their primary goals are to halt prolonged seizures quickly to prevent brain damage, ensure breathing stability, and identify underlying triggers like infection, low blood sugar, or trauma, often leading to neurology follow-up or hospital admission.
 

What does a short seizure look like?

Typical Absence Seizures

Typical absences are most common. The person suddenly stops all activity without any warning. It may look like he or she is staring off into space or just has a blank look.

Do seizures cause brain damage?

Although scientists and clinicians have long known that prolonged seizures, a condition referred to as "status epilepticus," kill brain cells, surprisingly little scientific evidence exists to support the notion that individual seizures do damage.

What side do you lay on when having a seizure?

You don't want the person experiencing a seizure to fall or hit their head on a counter or a piece of furniture. The ideal situation is to get them to the floor and clear an area around them. Lay on the left. Once you have them on the floor, try to position them on their left side so if they vomit, they don't choke.

What are the three words of seizure first aid?

When administering seizure first aid, follow the three S's: Stay, Safe, Side. The procedure remains the same when helping people of any age who are experiencing a seizure.

What is the number one symptom of POTS?

The classic symptom of POTS is a fast heartbeat. A person's heart rate may increase by more than 30 beats per minute or exceed 120 beats per minute within 10 minutes of standing. The rapid heartbeat usually improves when the person lies down again.

What medications should be avoided with POTS?

The Canadian Cardiovascular Society recommends the withdrawal of the following medications as they may aggravate POTS or mimic its symptoms: stimulants, alpha-adrenergic blockers, high doses of beta-adrenergic blockers, calcium channel blockers, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors ...

How much sleep does someone with POTS need?

Healthy teens usually need 8 to 9 hours of sleep and some people with POTS may need up to 10 hours, but sometimes oversleeping can make you feel worse. Please go to bed and wake up at the same time every day.

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