Panic Attack Semiology in Right Temporal Lobe Epilepsy: Illustrative Case Series.
Abstract number :
2.104
Submission category :
Year :
2001
Submission ID :
625
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M. Sazgar, BSc, MD, Medicine/Neurology, University of Alberta Hospital, Edmonton, AB, Canada; P.L. Carlen, MD, FRCPC, Neurology, Toronto Western Hospital, Toronto, ON, Canada; R. Wennberg, MD, FRCPC, Neurology, Toronto Western Hospital, Toronto, ON, Canad
RATIONALE: Panic attack semiology as a manifestation of epileptic seizures can lead to difficulties and delay in diagnosis. We present a case series to demonstrate the association of ictal panic and anxiety symptoms with partial onset seizures lateralized to the right temporal lobe.
METHODS: From 112 consecutive patients with intractable temporal lobe epilepsy (59 right, 53 left) referred for video-EEG monitoring at the Toronto Western Hospital between February 1997 and April 2001, 5 patients were identified (4 female, 1 male, aged 23 to 43 years) whose seizures had been diagnosed as panic attacks in the past. Their ictal symptomatology included feelings of panic and impending doom, hyperventilation, palpitation, diaphoresis, shortness of breath and generalized paresthesiae. Ictal panic was not identified in 72 patients with extratemporal epilepsy investigated during the same period.
RESULTS: All 5 patients were ultimately diagnosed with right temporal lobe epilepsy. Routine and long term EEG monitoring documented a right anterior to mid-temporal focus in all 5 patients. Brain MRI or pathology showed right mesial temporal sclerosis in 4 patients and gliosis at the margins of a previously resected right anterior temporal ganglioglioma in one.
CONCLUSIONS: Our case series provides further evidence to support the close relationship between panic attack symptomatology and symptomatic right temporal lobe epilepsy.