Schneider Thibault, Broc Nicolas, Leemann Beatrice, Schnider Armin, Nicastro Nicolas
Division of Neurorehabilitation, Department of Clinical Neurosciences, Geneva University Hospitals, 1206 Geneva, Switzerland.
Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland.
Brain Sci. 2023 Apr 26;13(5):726. doi: 10.3390/brainsci13050726.
(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.
（1）背景：惊恐发作通常被视为一种具有多种身体和心理症状的良性疾病。（2）病例报告：我们在此报告一名22岁患者的病例，该患者一年前曾有过一次运动性功能性神经障碍发作，此次出现伴有过度通气的惊恐发作，导致严重低磷血症、横纹肌溶解以及轻度四肢轻瘫。经磷酸盐替代和补液后，电解质紊乱迅速得到缓解。然而，出现了提示运动性功能性神经障碍复发的临床体征（双任务行走时有所改善）。包括脑和脊髓磁共振成像、以及针对低钾性周期性麻痹的神经电生理检查和基因检测在内的诊断性检查均无异常。数月后，四肢轻瘫、耐力缺乏和疲劳最终有所改善。（3）结论：本病例报告强调了一种精神疾病导致过度通气和急性代谢紊乱与功能性神经表现之间的相互关系。
