title: Panic versus epilepsy: a challenging differential diagnosis.
abstract: The differential diagnosis of panic attacks (PAs) from temporal lobe epilepsy is important and challenging. Despite advances in understanding the neural basis of psychiatric disorders, current practice strongly emphasizes dichotomous thinking of either "functional" PAs of psychiatric etiology or a seizure disorder. We present a case with PA features strongly suggestive of a seizure disorder. An extensive workup failed to resolve the dichotomy between functional and neurological. The possibility is raised that there may be degrees of abnormal hyperexcitability, leading to the emergence of symptoms, but not enough to generate large potentials that can be detected at the scalp.
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, School of Medicine, Detroit, MI, USA.
authors.forename: Nash N
authors.initials: NN
authors.lastname: Boutros
authors.forename: Klevest
authors.initials: K
authors.lastname: Gjini
authors.forename: John
authors.initials: J
authors.lastname: Moran
authors.forename: Harry
authors.initials: H
authors.lastname: Chugani
authors.forename: Susan
authors.initials: S
authors.lastname: Bowyer
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016584:Panic Disorder / Q000175:diagnosis*
keywords: EEG; MEG; PET scan; panic attacks; temporal lobe epilepsy