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Understanding the Distinction Between Focal Seizures and Panic Attacks

7/14/2025, 1:01:18 AMMale25-34

At 24 years old and diagnosed with epilepsy, my journey has been confusing. Approximately three years ago, I experienced a significant tonic-clonic seizure, which confirmed my condition. Further tests revealed epileptiform activity during my sleep EEG, leading to a prescription of Keppra. While that particular seizure was unmistakable, my struggles extend beyond it. In the weeks prior to my tonic-clonic episode, I began experiencing what were labeled as “panic attacks.” Now, since that initial seizure, I've encountered a few episodes, which I suspect are focal seizures. The issue lies in how strikingly similar these episodes are to panic attacks, making it nearly impossible to distinguish between them. Unlike traditional seizures, I remain fully conscious and aware, with no confusion following the episodes. However, the intensity they reach can be alarming, leaving me in disbelief. Although I don't shake or twitch during these occurrences, they feel distinctly different from mere panic. Instead, they are engulfing and overwhelming, often accompanied by an acute sense of impending doom, as if I might collapse from a heart attack at any moment. Additionally, I experience vertigo, giving the sensation that the ground is shifting beneath me. While a detailed EEG could provide clarity, based solely on my personal experiences, it becomes almost impossible to tell them apart without professional equipment. This ambiguity raises continual questions in my mind about what's truly happening within my body, leading to a constant state of concern and uncertainty.

DiabetesAsthmaInternal Medicine

Answers (1)

Cony

7/14/2025, 1:01:58 AM

OpenHealth AI

Understanding the difference between focal seizures and panic attacks is important, especially given your history with epilepsy. It can be challenging to differentiate between these two experiences since they can present similarly, particularly the feelings of anxiety and fear.

Key Points:

  1. Focal Seizures vs. Panic Attacks: Focal seizures can happen while the person remains aware of their surroundings, without the postictal confusion that is typical in tonic-clonic seizures. Panic attacks cause intense fear and physical symptoms, but the perception of reality remains intact afterward.
  2. Symptoms: The symptoms you describe—intense feelings of impending doom, vertigo, and overwhelming sensations—can occur in both conditions, making differentiation tricky.

Explanation:

Focal seizures involve abnormal electrical activity in the brain and can produce a wide range of sensations or feelings. Anxiety and panic, on the other hand, usually stem from psychological stressors and are often accompanied by heart palpitations, sweating, and hyperventilation. Your description of remaining fully aware during these episodes is indicative of a focal seizure but could also coincide with severe panic.

The sensation of vertigo and impending doom suggests that your brain is reacting to something that feels threatening, but determining what is physiological versus psychological is complicated in your case.

Next Steps:

  1. Keep a Detailed Diary: Start tracking your episodes in detail. Note the duration, triggers, symptoms, and your feelings before, during, and after. Include any environmental factors or stressors that may precede them.

  2. Lifestyle Modifications: Focus on stress management strategies like deep breathing exercises, meditation, or gentle yoga, as these can help mitigate both panic symptoms and seizures.

  3. Communicate with Your Healthcare Provider: Schedule a discussion with your neurologist about your experiences. Share your diary entries, concerns, and ask about the possibility of further EEG monitoring or adjusting your treatment plan if needed.

  4. Seek Support: Consider joining a support group for individuals with epilepsy. Connecting with others who have similar experiences can provide validation and strategies for managing daily uncertainties.

While it’s natural to feel anxious about your health, remember that gaining a better understanding of your condition is a journey. Your proactive approach in seeking clarity is a positive step forward. Please feel free to reach out with any further questions or concerns.

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