Events began one or two hours after sleep initiation and never occurred during the latter half of the patient’s sleep.
The event occurred about twice per week and lasted between thirty and sixty minutes each time. He had these stereotypical sensory and emotional symptoms every night in which the event occurred, but not during the daytime or before falling asleep. When expressing his symptoms, he used words such as “intolerable” and “feeling restless”. Following this sensory symptom, he felt an indescribable odd feeling. The event was described as an intolerable numbness in his upper and lower extremities. We report a patient who presented to the hospital with repeated awakening from sleep with numbness in the extremities followed by an indescribable odd feeling.Ī 68-year-old man presented to our department of neurology with six months of repeated awakening from sleep due to numbness followed by a strange feeling. Panic attacks may, on rare occasions, be misdiagnosed by neurologists and treated as partial seizures, and partial seizures may be overlooked by psychiatrists and treated as a neurotic disorder. Furthermore, there are many cases in which abnormalities are not objectively identified via electroencephalography (EEG) or polysomnography (PSG), again making them difficult to differentiate.
#Nocturnal panic attacks how to
Although psychiatric symptoms are well associated with patients diagnosed with epilepsy, there is no specific guideline on how to distinguish these. In particular, nocturnal panic disorder and auras related to epilepsy have significant subjective symptom overlap, making it difficult for clinicians to make an accurate diagnosis. These conditions should be carefully diagnosed among disorders with similar presentations but differences in pathophysiology, disease courses, and treatment. These nocturnal events allow for a very broad differential diagnosis because of the frequent overlap of clinical descriptors and lack of diurnal findings.
Paroxysmal events during sleep can be classified into parasomnias, sleep-related movements, psychiatric events, neurologic events, or medically related events.
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