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Ictal panic and interictal panic attacks: diagnostic and therapeutic principles.
1Department of Neurological Sciences, Rush University Medical Center, Rush Medical College at Rush University, 1653 West Congress Parkway, Chicago, IL 60612, USA. akanner@rush.edu
Neurologic Clinics
|December 22, 2010
Summary
Distinguishing between seizure-related panic attacks and primary panic disorder is crucial. While symptoms overlap, differences in duration and associated symptoms, aided by diagnostic tools, help differentiate these conditions for accurate diagnosis.
Area of Science:
- Neurology
- Psychiatry
Background:
- Panic attacks can manifest during or after seizures (ictal/postictal) or independently (interictal/primary).
- Both seizure-related and primary panic attacks share common symptomatology, complicating differential diagnosis.
Purpose of the Study:
- To elucidate the distinguishing features between ictal/postictal panic and interictal/primary panic attacks.
- To highlight diagnostic approaches for differentiating these conditions.
Main Methods:
- Clinical history review focusing on symptom duration and associated features.
- Discussion of adjunctive diagnostic tools including electroencephalography (EEG), neuroimaging, and prolactin level estimation.
Main Results:
- Ictal and postictal panic attacks are differentiated from primary panic attacks by their distinct duration and associated symptoms.
- A thorough patient history is often adequate for distinguishing these conditions.
Conclusions:
- Accurate differentiation between seizure-induced and primary panic attacks is essential for appropriate patient management.
- Diagnostic tools like EEG, neuroimaging, and prolactin level measurement can support clinical judgment when history alone is insufficient.
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