Anxiety disorders Anxiety disorders due to epilepsy: a case report

Epileptic patients present psychiatric disorders more frequently than general population and patients with other chronic medical conditions. Psychiatric disorders may co-occur with epilepsy and also they may be due to epilepsy. Personality changes, as well as psychosis, mood or anxiety disorders may occur in relation to epilepsy. Anxiety disorders due to epilepsy may appear as generalized anxiety disorder, panic disorder, phobia or obsessive compulsive disorder. The risk of having anxiety disorder is very high in focal epilepsy especially temporal lobe epilepsy but anxiety disorder can also be concurrent to frontal lobe epilepsy or generalized tonic-clonic epilepsy. Here we present a forty one years old, female patient with co-occurring anxiety disorder and epilepsy, who improved after initiation of an antiepileptic medication. The patient’s EEG had abnormalities especially in frontal lobe. In this case epileptic activation associated with anxiety disorder emerged as fear of swallowing, a specific phobia and carried features of generalized anxiety disorder. Upon initiation of antiepileptic medication, seizures stopped and symptoms of anxiety disorder disappeared in a short time. The patient’s psychiatric visits were once a fortnight. The patient stayed asymptomatic during the next two-year follow-up. This case report underlines the importance of differential diagnosis for underlying epilepsy in acutely occurring severe anxiety cases and efficacy of the proper medication, which is given for the underlying pathology on anxiety symptoms.