Panic disorder in a patient with traumatic brain injury: a case report and discussion

Individuals that may be especially susceptible to panic attacks in the rehabilitation setting are patients who have suffered traumatic brain injuries, post-concussion syndrome, lesions, or encephalopathy. An individual is described who suffered a traumatic brain injury and was determined to have suffered a panic attack during his rehabilitation stay. The manifestations of panic attacks are described, using the case report as an example. The psychological aetiology of panic disorders is also reviewed, and treatment options using four major classes of neuropharmacologic agents: benzodiazepines, tricyclic antidepressants, monoamide oxidase inhibitors, and serotonin reuptake inhibitors, are discussed. Given the increasing incidence and survival of patients with traumatic brain injuries, the complications of panic attacks and disorders will become more important; they are a serious condition that can affect an individual's lifestyle, employment, and relationships, and increase the risk of suicide. Rehabilitation specialists should be aware of the manifestations and management of panic attacks and come to appreciate that recognition of this treatable condition is important during all stages of rehabilitation.