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Panic disorder may coexist with epilepsy

Panic disorder may coexist with epilepsy and be a significant source of distress or disability. An aura of anxiety or fearfulness// (ictal fear) may be confused with panic attacks. Recent studies have reported evidence, demonstrated by positron emission tomography and magnetic resonance imaging, suggesting that the lesion in panic disorder may be in temporal lobes. The findings lend additional support to the idea that these illnesses may be related.

In line with earlier reports, a recent paper, to be published in Journal of Anxiety Disorders (available online 13 June 2005) posits the existence of a subgroup of panic attacks with the clinical features of the epileptic aura, and so must be considered and diagnosed as simple partial seizures (SPSs) with a psychic content. In the paper, research is presented to support a hypothesis that panic attacks, when they have the same clinical signs as the epileptic consciousness, should be diagnosed as partial seizures with a psychic content.

After setting out the four clinical signs defining it (suddenness, automatic nature, great intensity and strangeness), the authors made an extensive review of the literature in search of scientific information to support the hypothesis, which reveals a wealth of concurring scientific evidence, at both the clinical and preclinical levels, to support the hypothesis presented in this paper.

The authors found several major sets of information to support and reinforce their hypothesis that panic attacks occurring with the clinical signs characterizing the aura are to be interpreted as SPSs.

The authors conclude by saying that panic attacks observed clinically with the features of suddenness, strangeness, great intensity and automatic nature should be interpreted as SPSs.

They stress that the next step will be to fix scales and standard clinical interviews in order to objectify presence of such signs and thereby distinguish panic attacks of
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