Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders
INTRODUCTION: Ictal fear (IF) is one of the most frequent emotional auras. It is the sole or predominant manifestation of simple partial seizures or initial expression of a complex partial seizure. It is more often experienced in patients with mesial temporal lobe epilepsy (TLE), probably associated with mesial temporal structures, like the amygdala. Anxiety disorders are very common psychiatric disorders associated with epilepsy, with a prevalence of 15 to 25%. OBJECTIVES: To describe three patients with IF with refractory mesial TLE, also presenting the results of EEG, imaging exams, neuropsychological, quality of life and psychiatric evaluations. METHODS AND RESULTS: Three case reports of patients with refractory mesial TLE and IF followed up in the outpatient's clinic at the Epilepsy Section, Universidade Federal de São Paulo, Brazil, were submitted to presurgical evaluation and corticoamygdalohippocampectomy. Two patients presented ictal scalp-sphenoidal EEG onset on left side. Two patients had major depressive disorder in psychiatric evaluation. CONCLUSION: Although IF is the most frequent ictal psychological symptom, anxiety and mood disorders are very common psychiatric comorbidity in patients with epilepsy. It was concluded that differential diagnosis of interictal anxiety disorders, panic attacks and IF can be difficult, and requires careful management.
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Liga Brasileira de Epilepsia (LBE)
2006
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oai:scielo:S1676-264920060003000082007-05-21Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disordersRosa,Vivianne PellegrinoAraújo Filho,Gerardo Maria deRahal,Márcio AndrianiCaboclo,Luís Otávio Sales FerreiraSakamoto,Américo CeikiYacubian,Elza Márcia T. anxiety disorders epilepsy ictal fear neurology psychiatry INTRODUCTION: Ictal fear (IF) is one of the most frequent emotional auras. It is the sole or predominant manifestation of simple partial seizures or initial expression of a complex partial seizure. It is more often experienced in patients with mesial temporal lobe epilepsy (TLE), probably associated with mesial temporal structures, like the amygdala. Anxiety disorders are very common psychiatric disorders associated with epilepsy, with a prevalence of 15 to 25%. OBJECTIVES: To describe three patients with IF with refractory mesial TLE, also presenting the results of EEG, imaging exams, neuropsychological, quality of life and psychiatric evaluations. METHODS AND RESULTS: Three case reports of patients with refractory mesial TLE and IF followed up in the outpatient's clinic at the Epilepsy Section, Universidade Federal de São Paulo, Brazil, were submitted to presurgical evaluation and corticoamygdalohippocampectomy. Two patients presented ictal scalp-sphenoidal EEG onset on left side. Two patients had major depressive disorder in psychiatric evaluation. CONCLUSION: Although IF is the most frequent ictal psychological symptom, anxiety and mood disorders are very common psychiatric comorbidity in patients with epilepsy. It was concluded that differential diagnosis of interictal anxiety disorders, panic attacks and IF can be difficult, and requires careful management.info:eu-repo/semantics/openAccessLiga Brasileira de Epilepsia (LBE)Journal of Epilepsy and Clinical Neurophysiology v.12 n.2 20062006-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492006000300008en10.1590/S1676-26492006000300008 |
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Rosa,Vivianne Pellegrino Araújo Filho,Gerardo Maria de Rahal,Márcio Andriani Caboclo,Luís Otávio Sales Ferreira Sakamoto,Américo Ceiki Yacubian,Elza Márcia T. |
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Rosa,Vivianne Pellegrino Araújo Filho,Gerardo Maria de Rahal,Márcio Andriani Caboclo,Luís Otávio Sales Ferreira Sakamoto,Américo Ceiki Yacubian,Elza Márcia T. Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
author_facet |
Rosa,Vivianne Pellegrino Araújo Filho,Gerardo Maria de Rahal,Márcio Andriani Caboclo,Luís Otávio Sales Ferreira Sakamoto,Américo Ceiki Yacubian,Elza Márcia T. |
author_sort |
Rosa,Vivianne Pellegrino |
title |
Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
title_short |
Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
title_full |
Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
title_fullStr |
Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
title_full_unstemmed |
Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
title_sort |
ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders |
description |
INTRODUCTION: Ictal fear (IF) is one of the most frequent emotional auras. It is the sole or predominant manifestation of simple partial seizures or initial expression of a complex partial seizure. It is more often experienced in patients with mesial temporal lobe epilepsy (TLE), probably associated with mesial temporal structures, like the amygdala. Anxiety disorders are very common psychiatric disorders associated with epilepsy, with a prevalence of 15 to 25%. OBJECTIVES: To describe three patients with IF with refractory mesial TLE, also presenting the results of EEG, imaging exams, neuropsychological, quality of life and psychiatric evaluations. METHODS AND RESULTS: Three case reports of patients with refractory mesial TLE and IF followed up in the outpatient's clinic at the Epilepsy Section, Universidade Federal de São Paulo, Brazil, were submitted to presurgical evaluation and corticoamygdalohippocampectomy. Two patients presented ictal scalp-sphenoidal EEG onset on left side. Two patients had major depressive disorder in psychiatric evaluation. CONCLUSION: Although IF is the most frequent ictal psychological symptom, anxiety and mood disorders are very common psychiatric comorbidity in patients with epilepsy. It was concluded that differential diagnosis of interictal anxiety disorders, panic attacks and IF can be difficult, and requires careful management. |
publisher |
Liga Brasileira de Epilepsia (LBE) |
publishDate |
2006 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492006000300008 |
work_keys_str_mv |
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