title: Long-lasting seizure-related anxiety in patients with temporal lobe epilepsy and comorbid psychiatric disorders.
abstract: Ictal anxiety is a frequent epileptic symptom; it is usually brief, associated with objective clinical signs, and is not positively influenced by external factors, in contrast to psychiatric disorders. These criteria can, however, be misleading, especially in patients with psychiatric comorbidities. We report two patients with a history of drug-resistant right temporal lobe epilepsy, who developed long-lasting psychiatric symptoms, suggestive of exacerbation of their comorbid anxiety disorder. However, intracranial EEG data and [(18)F] FDG-PET suggested that these symptoms were related to seizure activity, highlighting the difficulties in differentiating ictal symptoms from psychiatric episodes in some patients with epilepsy and comorbid psychiatric disorders. [Published with video sequence].
authors.affiliation: Department of Functional Neurology and Epileptology and Institute of Epilepsies (IDEE), Hospices Civils de Lyon, Lyon, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Boulogne
authors.affiliation: Department of Functional Neurology and Epileptology and Institute of Epilepsies (IDEE), Hospices Civils de Lyon, Lyon, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Catenoix
authors.affiliation: Department of Functional Neurology and Epileptology and Institute of Epilepsies (IDEE), Hospices Civils de Lyon, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ryvlin
authors.affiliation: Department of Functional Neurology and Epileptology and Institute of Epilepsies (IDEE), Hospices Civils de Lyon, Lyon, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Rheims
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D055815:Young Adult
keywords: ictal anxiety; mesial status; panic attack; psychiatric seizure; temporal lobe epilepsy