Neurology Question 9

A 26-year-old woman is evaluated for a 10-year history of recurrent episodes of acute-onset feelings of fear and anxiety. These episodes initially occurred approximately four times per year but for the past 3 months have been occurring once or twice per month, especially when she is under stress. She describes the episodes as paroxysmal attacks of fear and anxiety associated with a dry mouth and a consistent “roller coaster” sensation in her stomach that typically last 15 seconds to 1 minute. With more intense attacks, she becomes momentarily confused; her boyfriend says she seems “fidgety” when this occurs. She feels well between episodes. Medical history is otherwise negative, and she takes no medication. On physical examination, vital signs are normal. All other findings from the general physical and neurologic examinations are unremarkable. A brain MRI and electroencephalogram are normal.

Which of the following is the most likely diagnosis?

A Frontal lobe epilepsy

B Juvenile absence epilepsy

C Panic disorder

D Psychogenic nonepileptic seizures

E Temporal lobe epilepsy

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