Panic attacks in an individual with bilateral selective lesions of the amygdala.
OBJECTIVE
To describe the unique case of a patient with panic attacks and bilateral selective amygdala lesions due to Urbach-Wiethe disease.


METHODS
Case report.


METHODS
Epilepsy Monitoring Unit, Medical University of Vienna. Patient A 38-year-old man with Urbach-Wiethe disease developed spontaneous panic attacks and depressive mood, which ceased after antidepressive treatment.


METHODS
Video electroencephalography monitoring, magnetic resonance imaging, and neuropsychological testing.


RESULTS
Extended video electroencephalography monitoring excluded an epileptic etiology of the panic attacks. Results of cranial magnetic resonance imaging showed bilateral selective calcifications of the whole amygdaloid complex. Neuropsychological testing revealed selective memory impairment of autobiographic episodes with preserved memory for autobiographic facts.


CONCLUSIONS
Our findings indicate that the occurrence of panic attacks does not critically depend on the integrity of the amygdala. Furthermore, the neuropsychological findings in our patient suggest that the amygdala represents an essential neural substrate for the processing of episodic autobiographic memories.
Wiest
Gerald
G
Department of Neurology, Medical University of Vienna, Vienna, Austria. gerald.wiest@meduniwien.ac.at
Lehner-Baumgartner
Eva
E
Baumgartner
Christoph
C
D000328:Adult; D000679:Amygdala / Q000473:pathology*; D000928:Antidepressive Agents / Q000627:therapeutic use; D002114:Calcinosis / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000188:drug therapy / Q000523:psychology; D004569:Electroencephalography; D006801:Humans; D051457:Hyaline Cartilage / Q000002:abnormalities / Q000473:pathology; D008065:Lipoid Proteinosis of Urbach and Wiethe / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D016584:Panic Disorder / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D010556:Personality Tests; D013577:Syndrome
D000928:Antidepressive Agents