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Seizure disorder is in the differential diagnosis of panic disorder.

Received September 22, 1999; revised December 1, 1999; accepted February 4, 2000. From the University of Minnesota, Departments of Psychiatry and Neurology, Medical School, Minneapolis, Minnesota. Address reprint requests to Dr. Daly, University of Minnesota, Department of Psychiatry, Medical School, F256/2B West, 2450 Riverside Avenue, Minneapolis, MN 55454-1495. Copyright 2000 The Academy of Psychosomatic Medicine. Differentiating between complex partial seizure disorder and psychiatric illness is challenging in psychiatric practice. Although seizure disorder occurs in 0.5%– 2% of the general population, the incidence of seizure disorder in psychiatric inpatients across all diagnoses is 1.0%– 4.0%. Distinguishing the symptoms of seizure disorder from those of psychiatric illness may be difficult because of the occasional similarity in presentation for these conditions. Clinicians rely on the patient’s presenting diagnosis when treating psychiatric disorders and often assume that psychiatric symptoms such as panic or anxiety result from psychiatric disorders. Neurologic referral is highly dependent on a psychiatrist’s ability to detect subtle signs and symptoms of a neurologic disorder. The case of Mr. A. provides an example of a psychiatric patient who required such consultation in order for his presenting symptoms to be adequately explained and treated. The purpose of this case report is to highlight the role of neurologic pathology in the presenting problems of some psychiatric cases.