SUDDEN AROUSALS FROM SLOW-WAVE SLEEP AND PANIC DISORDER - SUCCESSFUL TREATMENT WITH ANTICONVULSANTS - A CASE-REPORT

We report on a patient who suffered from treatment-resistent sudden ar ousals from sleep for 30 years and eventually developed daytime panic attacks. Polysomnography recorded three sudden arousals from sleep sta ge 4, with intense anxiety that was not associated with confusion or d ream recall. While resting wakeful electroencephalogram (EEG) was norm al, sleep-deprived EEG revealed increased left temporal theta activity and brain magnetic resonance imaging showed left hemispheric atrophy. Complete remission of symptoms could be obtained only with a combinat ion therapy of carbamazepine and clonazepam. Relations between atypica l sleep disorders, panic disorder and ictal brain activity are discuss ed. We conclude that in patients with atypical sleep and anxiety disor ders anticonvulsants could be a successful treatment approach.