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Mesial temporal lobe seizures presenting as anxiety disorders
G B Young1, P C Chandarana, W T Blume
1Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada.
The Journal of Neuropsychiatry and Clinical Neurosciences
|January 1, 1995
Summary
Simple partial seizures can mimic panic disorder. Diagnostic clues include seizure brevity, stereotypy, progression to complex partial seizures, and associated aphasia/dysmnesia, often linked to mesial temporal lesions.
Area of Science:
- Neurology
- Epileptology
- Psychiatry
Background:
- Distinguishing between epileptic seizures and panic attacks is crucial for accurate diagnosis and treatment.
- Simple partial seizures (SPS) can present with symptoms overlapping those of panic disorder, leading to diagnostic challenges.
Observation:
- Five patients presented with brief, simple partial seizures that clinically mimicked panic attacks.
- Key diagnostic features included seizures being briefer and more stereotyped than panic attacks.
- Some seizures progressed to complex partial seizures, and aphasia and dysmnesia were observed in some patients.
Findings:
- All patients had a single mesial temporal structural lesion.
- Routine waking electroencephalogram (EEG) was normal in two patients, highlighting the limitations of standard EEG.
- Inadequate response to anti-epileptic drugs (AEDs) prompted surgical intervention in four patients.
Implications:
- Early identification of subtle epileptic seizure patterns is vital to avoid misdiagnosis of panic disorder.
- Mesial temporal lobe epilepsy should be considered in patients with recurrent episodes resembling panic attacks.
- Surgical treatment, such as partial temporal lobectomy, can be effective in select cases, with three out of four patients becoming seizure-free.