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Biomedical subjects

P V Nickell

Publications and source records attributed to P V Nickell.

4 recordsLinked to original sources
PubMed1994

Panic attacks, complex partial seizures, and multiple meningiomas.

A 39-year-old woman presented with typical panic disorder symptoms of two years duration. Imipramine (IMI) treatment yielded complete remission of her symptoms for three years. At that time, however, her symptoms recurred. Neither increasing the IMI dose nor an adequate trial of fluoxetine controlled her symptoms. Further history revealed subtle changes in her symptoms suggestive of complex partial seizures. Scalp EEG was normal, but an MRI revealed multiple meningiomas. Her symptoms remitted completely on carbamazepine. This case illustrates the phenomenologic overlap between panic attacks and complex partial seizures, and a neuroanatomic overlap between the two syndromes is hypothesized.

Adult↗
PubMedDate not supplied

Dose-response effects of intravenous caffeine in normal volunteers.

The administration of caffeine has been developed as a chemical model for the study of anxiety. However, previous researchers investigating caffeine-induced anxiety states in humans have administered oral caffeine. In this dose-response study, we investigated the effects of blindly administered intravenous caffeine (3, 5, and 7 mg/kg) versus placebo in normal control subjects. We report the first series of subjects experiencing olfactory hallucinations (10 of 10 subjects, 24 of 30 infusions) immediately following intravenous caffeine infusion. In addition, consistent with our previous work with oral caffeine, we found dose-related increases in ratings of anxiety and blood levels of cortisol and lactate. One subject experienced a DSM-III-R panic attack. Further questioning revealed that his mother suffers panic attacks. Our findings of olfactory hallucinations are discussed within the context of localized limbic system dysfunction, noting the phenomenologic and possible neuroanatomic overlap between panic disorder and complex partial seizures.

Adult↗