Anxiety in patients with epilepsy: Systematic review and suggestions for clinical management

Beyenburg, Stefan; Mitchell, Alex J.; Schmidt, Dieter; Elger, Christian E.; Reuber, Markus

doi:10.1016/j.yebeh.2005.05.014

Cited by 330 publications

(300 citation statements)

References 98 publications

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“…Accordingly, the anxiolytics lorazepam (Schino et al, 1991), midazolam (Maestripieri et al, 1991) and diazepam (Cilia and Piper, 1997) have been shown to reduce scratching in anxiety models in nonhuman primates. Also, the shorter time spent in the nest box by epileptic animals may reflect enhanced anxiety, a mood disorder, which affects twice as many persons with epilepsy as in the general population and deteriorates the life quality of these patients (Beyenburg et al, 2005). Indeed it has been suggested that increased locomotor activity in marmosets (Barros et al, 2000), might be seen as indicative of anxiety.…”

Section: Discussionmentioning

confidence: 99%

Seizures triggered by pentylenetetrazol in marmosets made chronically epileptic with pilocarpine show greater refractoriness to treatment

et al. 2016

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a b s t r a c tThe efficiency of most of the new antiepileptic drugs (AEDs) on clinical trials still falls short the success reported in pre-clinical studies, possibly because the validity of the animal models is insufficient to fully represent the human pathology. To improve the translational value for testing AEDs, we propose the use of non-human primates. Here, we suggest that triggering limbic seizures with low doses of PTZ in pilocarpine-treated marmosets might provide a more effective basis for the development of AED. Marmosets with epileptic background were more susceptible to seizures induced by PTZ, which were at least 3 times longer and more severe (about 6 times greater frequency of generalized seizures) in comparison to naïve peers. Accordingly, PTZ-induced seizures were remarkably less attenuated by AEDs in epileptic than naïve marmosets. While phenobarbital (40 mg/kg) virtually abolished seizures regardless of the animal's background, carbamazepine (120 mg/kg) and valproic acid (400 mg/kg) could not prevent PTZinduced seizures in epileptic animals with the same efficiency as observed in naïve peers. VPA was less effective regarding the duration of individual seizures in epileptic animals, as assessed in ECoG (p = 0.05). Similarly following CBZ treatment, the behavioral manifestation of generalized seizures lasted longer in epileptic (p < 0.05), which were also more frequent than in the naïve group (p < 0.05). As expected, epileptic marmosets experiencing stronger seizures showed more NPY-and FosB-immunostained neurons in a number of brain areas associated with the generation and spread of limbic seizures. Our results suggest that PTZ induced seizures over an already existing epileptic background constitutes a reliable and controllable mean for the screening of new AEDs.

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Section: Discussionmentioning

confidence: 99%

Seizures triggered by pentylenetetrazol in marmosets made chronically epileptic with pilocarpine show greater refractoriness to treatment

et al. 2016

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“…Controlled studies of clinical therapy for anxiety disorders in patients with epilepsy have not been performed [8]. The epileptic symptoms in our patient showed no response to an SSRI, but completely disappeared after using carbamazepine.…”

Section: Discussionmentioning

confidence: 73%

“…However, ictal anxiety has also been reported in cases of extratemporal epilepsy [8]. In an invasive electrode study, ictal fear was associated with seizure spread involving the orbitofrontal, anterior cingulate, and temporolimbic cortices, irrespective of whether the seizure arose in the temporal or frontal region [12].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the correct diagnosis can easily be missed [5,7]. However, a few studies have suggested that compared with panic disorder, the typical features of partial seizures with ictal fear are a short duration of attacks (usually 1-2 min), the possibility of hallucinations, no agoraphobia, lack of response to conventional treatment for panic attacks, age older than 45 years at the onset of attacks, and abnormal EEG [7,8]. These characteristics are consistent with those found in our case.…”

Section: Discussionmentioning

confidence: 99%

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A patient with partial seizures manifested as panic attacks and auditory hallucination

Kosaka

Murata

Takahashi

et al. 2009

E&S

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We report a case of a 51-year-old man presenting anxiety and autonomic symptoms of panic-like attacks and simultaneous auditory hallucination. No abnormalities were evident in a physical examination but his cognitive function was impaired. Thus panic disorder or non-specific dementia with psychosis was initially suspected. Brain MRI was almost normal, except for an old right basal ganglia infarction and mild frontal atrophy. Neuroimaging studies showed reduced glucose metabolism over bilateral frontal, right temporal and right parietal regions. When a panic-like attack occurred, EEG documented ictal discharges in the right frontal and temporal areas. After successful treatment with carbamazepine, cognitive dysfunction and abnormal findings on brain imaging were improved. This case suggests that epilepsy should be suspected in a patients presenting with anxiety symptoms of panic-like attacks and hallucinations.

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“…Both epilepsy and depression are characterized by a chronic course and poor long-term psychosocial outcome [2]. Authors have identified psychiatric syndromes such as anxiety, depression, and behavioural affective and conversion disorders in people with epilepsy [8][9][10][11][12][13][14][15][16][17][18]. The risk for psychiatric disorders in people with epilepsy have been reported to be three to six times higher than observed in age matched apparently healthy population [1,15,18].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Correlates of Depression in Children and Adolescents with Epilepsy in a Nigeria Neuro-Psychiatric Hospital

OC¹,

CA²,

OA³

et al. 2012

J Clin Case Rep

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Anxiety in patients with epilepsy: Systematic review and suggestions for clinical management

Cited by 330 publications

References 98 publications

Seizures triggered by pentylenetetrazol in marmosets made chronically epileptic with pilocarpine show greater refractoriness to treatment

Seizures triggered by pentylenetetrazol in marmosets made chronically epileptic with pilocarpine show greater refractoriness to treatment

A patient with partial seizures manifested as panic attacks and auditory hallucination

Psychosocial Correlates of Depression in Children and Adolescents with Epilepsy in a Nigeria Neuro-Psychiatric Hospital

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