Temporal lobe epilepsy and the phobic anxiety-depersonalization syndrome. Part II: Practical and theoretical considerations

Roth, Martin; Harper, Max

doi:10.1016/s0010-440x(62)80022-4

Cited by 79 publications

(10 citation statements)

References 10 publications

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“…Panic with or without agoraphobia and agoraphobia without panic may precede the diagnosis of hyperthyroidism [38,41,42,94]. Panic attacks and anxiety could be the early manifestations of hypoparathyroidism [95], hypoglycemia [96], pheochromocytoma [51,97], brain tumors [52,54,55,56], temporal lobe epilepsy [98,99], and mitochondrial disorders [69,72]. In pancreatic cancer, restlessness, agitation and anxiety were the most common symptoms [100], together with frank panic attacks and generalized anxiety [101,102] (online suppl.…”

Section: Resultsmentioning

confidence: 99%

Mood and Anxiety Disorders as Early Manifestations of Medical Illness: A Systematic Review

Cosci

Fava²,

Sonino³

2014

Psychother Psychosom

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Background: Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a systematic review of the literature with qualitative data synthesis. Methods: MEDLINE, PsycINFO, EMBASE, Cochrane, and ISI Web of Science were systematically searched from inception to February 2014. Search terms were ‘prodrome/early symptom', combined using the Boolean ‘AND' operator with ‘anxiety/depression/mania/hypomania/irritability/irritable mood/hostility', combined with the Boolean ‘AND' operator with ‘medical illness/medical disorder'. PRISMA guidelines were followed. Results: A total of 21 studies met the inclusion criteria and were analyzed. Depression was found to be the most common affective prodrome of medical disorders and was consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS. Mania, anxiety and irritability were less frequent. Conclusions: Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.

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Section: Resultsmentioning

confidence: 99%

Mood and Anxiety Disorders as Early Manifestations of Medical Illness: A Systematic Review

Cosci

Fava²,

Sonino³

2014

Psychother Psychosom

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“…Roth and Harper in 1962 hypothesized that the temporal lobes might represent one substrate for phobicanxious patients with depersonalization-derealization (134). Today the panic disorder agoraphobia (PDA) is nosologically distinct from complex partial epilepsy (CPE), but there are clinical and pathogenetic hints of overlap between manifestations of the two disorders concerning the evaluation of psychosensorial phenomena in PDA or affective phenomena in CPE.…”

Section: Biologic Basis Of Anxiety Related To Epilepsymentioning

confidence: 99%

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

1999

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Summary: This chapter deals with some aspects of psychiatric disturbances in people with epilepsy. Because depression and its treatment are extensively described later in this issue, they are not discussed here. The same pertains to forced normalization. Key Words: Epilepsy-Anxiety-PsychosisDepress ion-Qua1 i ty of 1 i fe-Ps e u do s ei zure s-A n t idepressants-Antipsychotics-Antiepileptic drugs.Although most people with epilepsy lead a normal emotional and cognitive life, neurobehavioral problems can be found in a large number of patients. Higher rates of psychopathology are observed in people with epilepsy relative to the general population (1,2), to other neurologic control groups (3), and to people with chronic nonneurologic disorders (1,4). In particular, increased psychopathology is more common in temporal lobe epilepsy (TLE) than in generalized epilepsy (5). Nevertheless, many issues remain highly controversial, owing in part to several methodologic problems, such as the nosographic approach, the sample examined, the type of control groups, the comparison among nonhomogeneous forms of epilepsy, and the different antiepileptic drugs (AEDs).Psychiatric disturbances can be related either to involvement of brain structures (biologic pathogenesis) or to the chronic characteristics of epilepsy (psychosocial pathogenesis). These psychiatric symptoms may develop in relationship to the seizures (in prodromal, ictal, or postictal periods) but more commonly are present in a chronic interictal condition.The wide range of clinical diversity is related to the anatomic foci, to patterns of spread, and to biologic or psychological differences among patients. Interictal behavioral changes in epilepsy remain controversial and difficult to define, mainly because pathogenesis may be attributable to several factors, such as epilepsy itself, possible brain lesions, the AEDs prescribed, and psychosocial problems (6). On the other hand, the existence of cognitive changes in epilepsy is well established, and Addrress correspondence and reprint requests to Dr. Riccardo Tom at Dipartimento di Neuroscienze, via Cherasco 11, 10126 Torino, Italy.sometimes the presence of cognitive disorders can facilitate the appearance of psychiatric disturbances (7).One of the most widely discussed problems is the incidence of psychiatric pathology in epilepsy, with a wide range of values in the literature related to the type of study. Epilepsy is characterized by a broad spectrum of severity. Ideally, patients for study trials should be selected consecutively from a general epilepsy population, but most epidemiologic studies are carried out in centers for epilepsy and include many refractory subjects who demonstrate a range of pathologic disturbances more severe than those observed in the general population of patients with epilepsy. In community studies, the prevalence of associated psychiatric disorders is low, whereas in specialty referral centers, particularly those serving indigent populations, the prevalence can rise to 25-50%: Among patient...

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“…If CO 2 concentrations were increased still further, to greater than 40% of inspired air, narcosis and anesthesia occurred [288,289,290], whereas if high concentrations of CO 2 were rapidly withdrawn, associated with a rapid decrease in blood CO 2 , clonic type seizures occurred [291,292]. CO 2 is rapidly transported into CNS and cerebral spinal fluid (CSF) with a time constant of 2.7 min [293] with an active transport of H + out of cells and consumption of organic acids [294]. Although acute CO 2 effects in CNS are difficult to measure, transmembrane fluxes of HCO3 - and H + active transport were measureable in 45 min and return of cell pH to normal can take as long as 48 h [295].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, confusion can also occur with respect to what has been called chronic hyperventilation syndrome [330], panic disorder [331,332], hyperventilation induced seizures [333], phobic anxiety depersonalization syndrome [293] and Rett’s syndrome [334]. Hyperventilation induced seizures, albeit rarely tonic-clonic or partial [333], has been the subject of many case reports [300,329,335].…”

Section: Discussionmentioning

confidence: 99%

Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia

2013

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Olfactory hallucinations without subsequent myoclonic activity have not been well characterized or understood. Herein we describe, in a retrospective study, two major forms of olfactory hallucinations labeled phantosmias: one, unirhinal, the other, birhinal. To describe these disorders we performed several procedures to elucidate similarities and differences between these processes. From 1272, patients evaluated for taste and smell dysfunction at The Taste and Smell Clinic, Washington, DC with clinical history, neurological and otolaryngological examinations, evaluations of taste and smell function, EEG and neuroradiological studies 40 exhibited cyclic unirhinal phantosmia (CUP) usually without hyposmia whereas 88 exhibited non-cyclic birhinal phantosmia with associated symptomology (BPAS) with hyposmia. Patients with CUP developed phantosmia spontaneously or after laughing, coughing or shouting initially with spontaneous inhibition and subsequently with Valsalva maneuvers, sleep or nasal water inhalation; they had frequent EEG changes usually ipsilateral sharp waves. Patients with BPAS developed phantosmia secondary to several clinical events usually after hyposmia onset with few EEG changes; their phantosmia could not be initiated or inhibited by any physiological maneuver. CUP is uncommonly encountered and represents a newly defined clinical syndrome. BPAS is commonly encountered, has been observed previously but has not been clearly defined. Mechanisms responsible for phantosmia in each group were related to decreased gamma-aminobutyric acid (GABA) activity in specific brain regions. Treatment which activated brain GABA inhibited phantosmia in both groups.

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Temporal lobe epilepsy and the phobic anxiety-depersonalization syndrome. Part II: Practical and theoretical considerations

Cited by 79 publications

References 10 publications

Mood and Anxiety Disorders as Early Manifestations of Medical Illness: A Systematic Review

Mood and Anxiety Disorders as Early Manifestations of Medical Illness: A Systematic Review

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia

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