Panic disorder in epilepsy.

A 51-year-old woman showed structural epilepsy following an atypical, nontraumatic intracranial hemorrhage in the right frontal area. Despite successful seizure control with lamotrigine, she developed severe morning anxiety and panic attacks, leading to agoraphobia, social withdrawal, and psychogenic nonepileptic seizures. Neuropsychiatric and psychological assessments confirmed an anxiety disorder with no significant symptoms of depression. The patient received various psychopharmacological treatments with limited success. This case report illustrates that managing panic disorder in patients with structural epilepsy requires a comprehensive treatment approach that includes pharmacotherapy and psychotherapy. Differential diagnosis and accurate treatment are crucial because of the symptom overlap between panic attacks and

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CB has received support from and/or has served as a paid consultant for Angelini, Arvelle, Eisai, GW Pharmaceuticals, Jazz Pharmaceuticals, Johnson & Johnson, Marinus, UCB Pharma, and Xenon. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.