Windows to the Brain

  • Kirshner H
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The differential diagnosis of patients who experience symptoms of paresthesias, derealization, dizziness, chest pain, tremors, and palpitations can be quite challenging. These symptoms occur across a wide range of disorders, including cardiac, psychiatric, and neurological disorders. It can be particularly difficult to differentiate partial seizures without generalization of temporal lobe origin from panic disorder, as all of the above symptoms can be found in both conditions. In fact, panic disorder has been found to be the most common condition that must be distinguished from seizure disorder. Although the current diagnostic classification defines panic disorder and simple partial seizure disorder as two separate entities, they clearly share similar features and common symptoms and may occur as comorbidities. Rarely, patients diagnosed with panic disorder later show evidence of mesial temporal sclerosis and EEG-proven seizure foci. The close clinical presentations of these two conditions call for a very thorough medical evaluation of those patients with preliminary suspicions of panic disorder and symptoms similar to a seizure aura. Nuclear imaging may prove helpful in this endeavor, as very early work may indicate divergent scan findings-especially with receptor specific ligands. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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  • Howard S. Kirshner

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