Panic disorder with agoraphobia following tuberculous meningitis

Brain damage has been reported to be associated with the onset of panic disorder. We report a case of panic disorder with agoraphobia (PDA) after recovery from tuberculous meningitis (TBM). The CT brain showed cerebral oedema and basal meningeal enhancement. On recovery from the TBM, the patient developed PDA as well as features of depression. She was treated with alprazolam, amitryptline and underwent behaviour therapy over a period of 18 months. At the end of this period, the patient showed improvement but had not reached her pre-morbid level of functioning. The possibilities of brain damage as aetiological factors for PDA are discussed.