Temporal lobe epilepsy presenting as panic attacks: Detection of interictal hypometabolism with positron emission tomography

Cerebral glucose metabolism was studied using positron emission tomography (PET) in a 13-year-old girl with a history of panic attacks that were thought to be of psychiatric origin. Positron emission tomography imaging revealed marked right temporal lobe hypometabolism and magnetic resonance imaging (MRI) detected T2 changes consistent with right mesial temporal sclerosis. Electroencephalogram (EEG) studies 3 years later confirmed a primary diagnosis of right temporal lobe epilepsy. As shown by this case and one other, PET and MRI imaging of patients with panic disorder who are thought to have epilepsy may be helpful in leading to definitive electrographic studies that confirm temporal lobe epilepsy as the primary diagnosis.