Abstracts

RATIONALE: to further elucidate the relations between panic disorder and epilepsy and the clinical significance of epileptic seizures with prominent "psychiatric" and " affective" symptomatology. METHODS:during the past five years we found 7 patients (4 female, 3 male, aged 23 to 49 years) who had been treated for a wide variety of psychiatric disturbances (usually "panic attacks") over a span of several (3 to 20) years before a diagnosis of partial seizures was made. RESULTS: the history of these patients consisted of brief episodes (seconds to a few minutes) characterized by dizziness (2), fear (3), hyperventilation (2), tremor (2), palpitations (3), rage attacks (2), and depersonalization (1) in various combinations. A condition of subcontinuous and marked anxiety was present in 3 patients. In retrospect, these paroxysmal episodes could be attributed to temporal lobe seizures with psychic, affective and autonomic symptomatology. Tonic- clonic seizures were present in all patients and often led to the correct diagnosis. Routine and sleep EEGs revealed a right temporal lobe focus in all cases and asynchronous left temporal spikes in two. Etiology included slowly progressive temporal tumours (2), cavernous angioma (2), temporal atrophy (1) and cerebral lupus (1). CONCLUSIONS: we suggest that temporal lobe seizures with prominent psychic and affective symptomatology resembling panic attacks may indicate a structural involvement of the right temporal lobe.