Panic attacks, complex partial seizures, and multiple meningiomas.
A 39-year-old woman presented with typical panic disorder symptoms of two years duration. Imipramine (IMI) treatment yielded complete remission of her symptoms for three years. At that time, however, her symptoms recurred. Neither increasing the IMI dose nor an adequate trial of fluoxetine controlled her symptoms. Further history revealed subtle changes in her symptoms suggestive of complex partial seizures. Scalp EEG was normal, but an MRI revealed multiple meningiomas. Her symptoms remitted completely on carbamazepine. This case illustrates the phenomenologic overlap between panic attacks and complex partial seizures, and a neuroanatomic overlap between the two syndromes is hypothesized.
Nickell
P V
PV
Department of Behavioral medicine and Psychiatry, West Virginia University School of Medicine, Morgantown 26506-9137, USA.
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D002552:Cerebral Ventricles / Q000473:pathology; D017029:Epilepsy, Complex Partial / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D008579:Meningioma / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D016584:Panic Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology
D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine