Panic Attack, Severe Hypophosphatemia and Rhabdomyolysis in the Setting of a Motor Functional Neurological Disorder.
Thibault SchneiderNicolas BrocBeatrice LeemannArmin SchniderNicolas NicastroPublished in: Brain sciences (2023)
(1) Background: panic attack is often regarded as a benign disorder with variable physical and psychological symptoms. (2) Case Presentation: We here report the case of a 22-year-old patient known for an episode of motor functional neurological disorder a year earlier who presented a panic attack with hyperventilation causing severe hypophosphatemia and rhabdomyolysis, as well as mild tetraparesis. Electrolyte disturbances quickly resolved after phosphate substitution and rehydration. However, clinical signs suggesting a relapse of a motor functional neurological disorder appeared (improved walking with dual tasks). Diagnostic workup, including brain and spinal magnetic resonance imaging, as well as electroneuromyography and genetic testing for hypokalemic periodic paralysis, was unremarkable. Tetraparesis, lack of endurance, and fatigue eventually improved after several months. (3) Conclusions: the present case report highlights the intertwined relationship between a psychiatric disorder, leading to hyperventilation and acute metabolic disturbances, and functional neurological manifestations.
Keyphrases
- case report
- magnetic resonance imaging
- acute kidney injury
- cerebral ischemia
- early onset
- mental health
- computed tomography
- spinal cord
- drug induced
- subarachnoid hemorrhage
- sleep quality
- blood brain barrier
- respiratory failure
- solid state
- brain injury
- lower limb
- extracorporeal membrane oxygenation
- functional connectivity
- depressive symptoms