How To Differentiate Between Panic Attacks And Partial Seizures
Talking to your doctor helps in identifying the correct condition. Other than this, you can identify a panic attack and a partial seizure for what they are by:
- Panic attacks have a tendency to last longer whereas seizures dont.
- People suffering from seizures also have repetitive motion or actions.
- People suffering from seizures can be non-responsive whereas, a person suffering from panic attack can respond to others.
The crux of the matter is panic attacks and seizures are both different medical conditions, their similarities notwithstanding. Also the types of seizures that resemble a panic attack are partial seizures. The full blown epileptic seizures are nothing like panic attacks.
Please do not delude yourself into thinking that your panic attacks are seizures. Partial seizures do resemble panic attacks, but this occurs rarely and that too in a person who is already prone to a seizure disorder.
What Is A Seizure
A seizure is an abnormal or excessive electrical discharge or activity of neurons in the brain which causes the brain cells to misfire, send wrong signals and send them too rapidly. This abnormal brain activity in turn causes physical symptoms that are varied and many, lasting from a few seconds to several minutes. Some symptoms may occur before the actual seizure takes place such as sudden fear or anxiety, dizziness, changes in vision, jerky movement of the limbs, or headaches. The symptoms of an ongoing seizure include loss of consciousness followed by confusion, uncontrollable muscle spasms, frothing at the mouth, clenching of teeth, rapid eye movement, loss of control in the bladder or bowel function, or even changes in mood.
There are many situations or conditions that either directly trigger a seizure or increase the risk of having one. These risk factors include brain injury or infection, brain tumor, stroke, intake of varied substances from alcohol to drugs , as well as stress. Other risk factors may be genes, hormonal imbalance, or medical conditions such as Alzheimers disease, lupus or meningitis. The treatment of seizures may be medicine based as doctors may prescribe antiepileptic drugs which adjust or reduce excessive electrical brain activity. Surgery may also be performed if the cause of the seizure is determined to be caused by or originates in a specific part of the brain.
Can Panic Attacks And Seizures Be Confused
When considering a diagnosis of epilepsy, it is very important to distinguish it correctly from other disorders.
- Some people with high levels of anxiety can experience panic attacks, which have intense feelings of nervousness, fear, and the sudden onset of bodily symptoms such as sweating, hyperventilation, fast heartbeat, and flushing of the skin.
- In some cases, panic attacks have been misdiagnosed as epilepsy, and epilepsy has even been misdiagnosed as panic attacks! Because these symptoms of anxiety can be present during a seizure, in many cases the two are hard to differentiate.
- In extreme cases, hyperventilation caused by anxiety can trigger a convulsion, which can further complicate the diagnosis.
- Because the panic attacks occur suddenly and without warning, they are extremely frightening the person usually believes that they represent a serious medical condition. Because panic attacks and seizures can be so similar, it is important to use techniques such as MRI and EEG to differentiate between them.
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About Anxiety & Panic Attacks
People suffering from anxiety disorder always have a tendency to think the worst of everything. People suffering from anxiety and panic attacks focus more on the negative. Anxiety disorder is a condition where the patients brain tends to concentrate on the worst case scenarios. So, this means that if the patient is suffering from a panic attack, then that patient is more prone to thinking that the panic attack is caused by something worse, such as seizure.
Habit Of Pushing Back Unwanted Memories
Many people respond to traumatic or distressing memories by burying them or pushing them away.
If your worries overwhelm and exhaust you to the point where you begin to have trouble functioning, you might try to block or suppress them in order to cope.
You might not forget a specific event entirely, but refusing to think about it can blur the details and help it fade from the forefront of your memory.
Suppression might seem beneficial, but it doesnt help you address the source of the problem. Unaddressed anxiety can get worse and have an even greater effect on memory and concentration over time.
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Anxiety As A Symptom Of Epilepsy
Anxiety is not a purely psychological or psychosocial phenomenon. It also can occur as a direct result of neurobiological factors like abnormal brain function and seizures.
- Some factors that are responsible for seizures may also be responsible for anxiety, which can manifest itself in various ways in epilepsy. For instance, many people report feelings and symptoms of anxiety as part of their “aura.”
- Some components of anxiety, such as obsessiveness and agitation, may be seen in people with epilepsy-related psychosis.
- Similar anxiety can be seen in people with brain damage.
- Although the exact relationship between brain abnormalities and anxiety is extremely complex and not very well understood, it is clear that there is a relationship. Both psychological and biological components of anxiety are particularly apparent in people with seizures.
Driving Regulations For Dissociative Seizures
Driving regulations for the UK are set by the Driver and Vehicle Licensing Agency . You will need to stop driving and tell the DVLA that you have dissociative seizures. You may be able to apply for a new licence once you have been seizure free for three months.
If seizures are considered likely to happen while driving, a specialist review would also be needed. These regulations are based on the risks of having a seizure while driving.
Visit gov.uk/driving-medical-conditions for more information.
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Symptoms Diagnosis And Treatment
Video-EEG monitoring is the standard diagnostic procedure for PNES. This test can record clinical findings to correlate with the brain’s electrical activity. For proper differentiation, a typical episode should be recorded, verified by the patient or family, and evaluated.
Common features:
- PNES events typically occur when the individual is awake. They often last for longer than epileptic seizures and may end abruptly.
- Certain movements are also more commonly seen in PNES than in epileptic seizures, such as thrashing and pelvic thrusting.
- The absence of motor features and prolonged body limpness are more often seen in cases of PNES than cases of epilepsy.
Psychotherapy, including cognitive behavioral therapy, is regarded as the best approach to treating PNES. Antiepileptic drugs have not found to be effective.
The Confusion Between Panic Attacks & Partial Seizures
Panic attacks occur suddenly and can be so overwhelming that the patient feels out of control. In such cases, people tend to look for other causes or refuse to believe that it can be a panic attack. These days, for every little problem, people are searching online about it and thus there are innumerable websites and forums that tell you that what you are suffering from may be different from panic attacks, such as that it could be a partial seizure.
Partial seizures can resemble panic attacks however, this occurs in very rare cases and even if they occur, then it is seen in patients who are already at risk for epilepsy. Similarly, sometimes panic attacks can be so severe to the extent that they look like seizures however, this scenario is also not common.
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Offer Comfort To Your Dog During A Panic Attack
If your dog is having a panic attack and he comes to you for attention, you can pet, hug, or hold him if that helps ease the signs of his panic.
Depending on how intense the episode is, you can try to:
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Distract and redirect your dog to play with toys
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Take your dog for a walk
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Practice basic dog obedience cues or tricks for high value-treats
Other dogs may enjoy being pet, brushed, or massaged by their owners.
You should also provide a place for your dog to hide. Play calming classical music and make sure the space is free of external stimulants . You can also use dog pheromone sprays or plug-in diffusers to help reduce anxiety in that location.
What Are The Symptoms
Although dissociative seizures start as an emotional reaction, they cause a physical effect. Features of the seizure can include palpitations , sweating, a dry mouth, and hyperventilation .
Some features of dissociative seizures are very similar to epileptic seizures. These physical features may include loss of awareness, loss of sensation, and loss of control of bodily movement.
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Anxiety Can Cause Seizures In Those With Epilepsy
If you have already been diagnosed with epilepsy then yes, anxiety can cause seizures. Severe stress is a very common seizure trigger, and those with severe anxiety often experience severe stress.
However, it should be noted that this is far more common with those who already have epilepsy. It is very rare for someone to have their first seizure as a result of anxiety. Those who already have epilepsy are usually aware of the risks.
Similarly, the age groups are very different. Most people have their first panic attacks in their early to mid-twenties . They may also have panic attacks as a response to pregnancy or stress.
Epileptics tend to have their first seizures while very young – usually as infants, or as the result of head trauma, or as they reach retirement age. Developing epilepsy between the ages of adolescence and adulthood is exceedingly rare.
So while anxiety can cause seizures, it is very rare for anxiety to cause seizures in those that do not already know they have a seizure disorder.
How Stress Develops And How It Affects The Body
Stress is a natural physical response by the body. It is believed to be associated with the primitive flight or fight instinct. When confronted by a challenge, the body responds by releasing a hormone called adrenalin which gives extra strength to the muscles and sharpens our responses. This physical reaction is designed to provide a quick response to a challenging situation. The stress reaction can become a problem, however, if there are too many challenges to the body at any one time.
Just how much stress is too much varies for each individual. You can recognise when you have too much stress in your life by watching for certain changes in your behaviour. These changes might include missing meals, drinking too much alcohol or being unable to rest and relax.
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Other Physical Effects Of Panic Attacks:
Now that weve discussed some of the primary physiological causes of panic attacks, there are a number of other effects that are produced by the activation of the sympathetic nervous system, none of which are in any way harmful.
For example, the pupils widen to let in more light, which may result in blurred vision, or seeing stars, etc. There is a decrease in salivation, resulting in dry mouth. There is decreased activity in the digestive system, which often produces nausea, a heavy feeling in the stomach, and even constipation. Finally, many of the muscle groups tense up in preparation for fight or flight and this results in subjective feelings of tension, sometimes extending to actual aches and pains, as well as trembling and shaking.
Overall, the fight/flight response results in a general activation of the whole bodily metabolism. Thus, one often feels hot and flushed and, because this process takes a lot of energy, the person generally feels tired and drained.
Are Panic Attacks Related To Epilepsy
Some people with epilepsy are told they are having panic attacks, when they are actually experiencing seizures. And some people with panic attacks are wrongly diagnosed with epilepsy. Occasionally breathing too fast during a panic attack can trigger an epileptic seizure, which can also complicate a diagnosis.
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Suggestions And Future Research
When compared with depression, less attention has been focused on anxiety disorders in epilepsy. The factors that have been suggested for the increased risk of anxiety disorders in epilepsy are reviewed in Figure 1. For the management of this disabling comorbidity, different strategies including psychosocial, behavioral and medicational interventions are found to be helpful. However, for an effective management, gaining optimal seizure control must be the first step. Without total seizure control, complete treatment of anxiety symptoms is considered unlikely . Further research is needed to better examine the specific phenomenology of anxiety disorders in patients with epilepsy in order to guide clinicians about when psychiatric referrals are needed.
Figure 1.
Overview of the factors associated with increased risk of anxiety disorders in patients with epilepsy
Neurobiological factors: The role of of amygdala and GABA receptors
Unpredictability of seizures, the fear of death, feeling of poor control over seizures and the perceived stigma
Epilepsy related factors: Higher seizure frequency, focal epilepsy types and epilepsy surgery
Age of the patients: In adults, later onset of epilepsy. In pediatric population, older age
Role of antiepileptic drugs : AED polytherapy and the effects of spesific AED on anxiety symptoms
Symptoms That Mimic Epilepsy Linked To Stress Poor Coping Skills
Based on their clinical experience and observations, a team of Johns Hopkins physicians and psychologists say that more than one-third of the patients admitted to The Johns Hopkins Hospitals inpatient epilepsy monitoring unit for treatment of intractable seizures have been discovered to have stress-triggered symptoms rather than a true seizure disorder.
These patients returning war veterans, mothers in child-custody battles and over-extended professionals alike have what doctors are calling psychogenic non-epileptic seizures . Their display of uncontrollable movements, far-off stares or convulsions, Johns Hopkins researchers say, are not the result of the abnormal electrical discharges in the brain that characterize epilepsy, but instead appear to be stress-related behaviors that mimic and are misdiagnosed as the neurological disorder.
One potent clue, the researchers note, is that antiseizure medications fail to stop these patients symptoms, suggesting nothing is physically wrong with their brains electrical activity. The researchers also say the diagnoses appear to be on the rise, at least by what they have seen in recent months.
When the team discovers individuals who, using a computer analogy, dont have a hardware problem but a software glitch, they get the good news. Often, Krauss says, symptoms go away quickly. But, Brandt says, such patients often need cognitive behavior therapy to help them develop more effective coping skills.
For more information:
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How Is Anxiety Related To Epilepsy
Anxiety can be quite significant in the life of a person with epilepsy. In any medical illness, people may become anxious after the diagnosis of their condition. But anxiety is also related to epilepsy in more specific ways. It can occur not only as a reaction to the diagnosis, but also as a symptom of the epilepsy or as a side effect of seizure medicines.
Understanding The Relation Between Anxiety And Seizures
People suffering from panic attacks tend to fall into the trap where they are convinced that their panic attacks is something more serious. If you have not been diagnosed with epilepsy, then you have to accept the reality that what you are suffering from is in fact panic attacks and only panic attacks from acute anxiety and stress.
Whether you are suffering from panic attacks or seizures, it is important to talk to your doctor regarding the diagnosis and the best treatment plan. People suffering from epilepsy are at increased risk for more seizures due to acute stress of impending panic attack or seizure.
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What Are Psychogenic Non
Most people dont understand what is a pseudoseizure? Well, psychogenic non-epileptic seizures or pseudoseizures are different from neurological seizures caused by abnormal brain activity. Often abbreviated as PNES, these are brain responses to stress or anxiety in extreme levels to be considered psychiatric. PNES is classified among functional neurological disorders or conversion disorders.
Typically, these disorders occur due to emotional stressors that cause physical signs that cant be justified with other underlying conditions. PNES usually affects those who struggle to manage anxiety, stress, and traumatic emotions using traditionally accepted coping mechanisms. Once the emotions become overwhelming enough, it shuts down the bodys defense mechanism.
Other Forms Of Treatment
Psychotherapy is the recommended treatment for dissociative seizures. Psychotherapy is the name for a group of different talking therapies . Mental health professionals, including psychiatrists and psychologists, are trained in different forms of psychotherapy.
Cognitive behavioural therapy is often recommended. CBT looks at how you think about things, how this affects you physically and emotionally, and how it affects what you do . By changing the way you think about things, such as how you think about yourself, other people, and the world around you, this may change the way that you behave. CBT tends to focus on how things ar affecting you in the present, and ways to help you to view current situations more positively, and cope with stressful events.
CBT can take several months or longer as it may take time for you to feel comfortable talking about your experiences and feelings.
See more about epilepsy treatment.
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Teen’s Brain Tumor Misdiagnosed As Anxiety
Jennifer Mizrahi remembers the first phone call from her daughter telling her, Chasin is panicking! He was in a store with his dad and his older brother and sister, and suddenly the 12-year-old felt strange and nervous. Jennifer tried to reassure Chasin over the phone, telling him to take a deep breath and to drink some water. The whole episode lasted less than a minute and then he was fine. No one paid much attention to this incident it was a one-time thing.
Then it happened again a few months later.
This time Jennifer witnessed the whole episode unfold. He got really nervous, and quickly rattled off, Somethings wrong. I feel really strange, I need to take a walk, I need some water, Jennifer says. He looked alert and his eyes were wide open. Fifty seconds later, he felt fine.
The family pediatricians reaction was that all kids have a little angst and he thought it might be related to stress from Chasins parents divorce. He examined Chasin but never ran any tests. The pediatrician said he thought Chasin was experiencing panic attacks and supported the techniques Jennifer had already taught Chasin: breathe deeply, drink some water, and maybe go for a walk. The doctor didnt think it was anything serious or dangerous. In fact, to make light of Chasins symptoms, he suggested they give the attacks a nickname, Fred.
The Roadblocks and the Signs
Chasin & Jennifer Mizrahi
Jennifer Mizrahi’s Notes
The Real Diagnosis
Chasin Mizrahi