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Episodic paroxysmal anxiety

MedGen UID:
923185
Concept ID:
C1387805
Mental or Behavioral Dysfunction
HPO: HP:0000740

Definition

Recurrent attacks of severe anxiety, which occur without restriction to any particular situation or set of circumstances, are therefore unpredictable. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEpisodic paroxysmal anxiety

Conditions with this feature

Paragangliomas 3
MedGen UID:
340200
Concept ID:
C1854336
Disease or Syndrome
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.
Paragangliomas 4
MedGen UID:
349380
Concept ID:
C1861848
Neoplastic Process
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.
Paragangliomas 1
MedGen UID:
488134
Concept ID:
C3494181
Neoplastic Process
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.

Professional guidelines

PubMed

Lee CH, Lee SB, Kim YJ, Kong WK, Kim HM
Otol Neurotol 2014 Dec;35(10):e324-30. doi: 10.1097/MAO.0000000000000559. PMID: 25144643
Tsai JD, Chou IC, Tsai FJ, Kuo HT, Tsai CH
Acta Paediatr Taiwan 2005 May-Jun;46(3):138-42. PMID: 16231560
Magliulo G, Bertin S, Ruggieri M, Gagliardi M
Eur Arch Otorhinolaryngol 2005 Aug;262(8):627-30. Epub 2005 Jan 22 doi: 10.1007/s00405-004-0784-2. PMID: 15666205

Recent clinical studies

Etiology

Hassan A
Tremor Other Hyperkinet Mov (N Y) 2023;13:9. Epub 2023 Mar 28 doi: 10.5334/tohm.747. PMID: 37008993Free PMC Article
Mosca S, Martins J, Temudo T
Rev Neurol 2022 Feb 16;74(4):135-140. doi: 10.33588/rn.7404.2021326. PMID: 35148422
Formeister EJ, Chae R, Wong E, Chiao W, Pasquesi L, Sharon JD
Ann Otol Rhinol Laryngol 2022 Apr;131(4):403-411. Epub 2021 Jun 13 doi: 10.1177/00034894211025416. PMID: 34121469
Gunawardane PTK, Grossman A
Adv Exp Med Biol 2017;956:239-259. doi: 10.1007/5584_2016_76. PMID: 27888488
Cass SP, Furman JM, Ankerstjerne K, Balaban C, Yetiser S, Aydogan B
Ann Otol Rhinol Laryngol 1997 Mar;106(3):182-9. doi: 10.1177/000348949710600302. PMID: 9078929

Diagnosis

Hassan A
Tremor Other Hyperkinet Mov (N Y) 2023;13:9. Epub 2023 Mar 28 doi: 10.5334/tohm.747. PMID: 37008993Free PMC Article
Mosca S, Martins J, Temudo T
Rev Neurol 2022 Feb 16;74(4):135-140. doi: 10.33588/rn.7404.2021326. PMID: 35148422
Gunawardane PTK, Grossman A
Adv Exp Med Biol 2017;956:239-259. doi: 10.1007/5584_2016_76. PMID: 27888488
Dulac O
Epilepsia 2001;42 Suppl 3:23-6. doi: 10.1046/j.1528-1157.2001.042suppl.3023.x. PMID: 11520318
Cass SP, Furman JM, Ankerstjerne K, Balaban C, Yetiser S, Aydogan B
Ann Otol Rhinol Laryngol 1997 Mar;106(3):182-9. doi: 10.1177/000348949710600302. PMID: 9078929

Therapy

Hassan A
Tremor Other Hyperkinet Mov (N Y) 2023;13:9. Epub 2023 Mar 28 doi: 10.5334/tohm.747. PMID: 37008993Free PMC Article
Gupta J, Badal S, Anand V, Jauhari P, Chakrabarty B, Gulati S
Neurol India 2022 Jan-Feb;70(1):312-314. doi: 10.4103/0028-3886.338670. PMID: 35263902
Dayasiri K, Weerapperuma N, Wright J, Anand G
BMJ Case Rep 2021 Feb 5;14(2) doi: 10.1136/bcr-2020-235112. PMID: 33547116Free PMC Article
Forbes D, Fairbrother S
Aust Fam Physician 2008 Jan-Feb;37(1-2):33-6. PMID: 18239750
Dulac O
Epilepsia 2001;42 Suppl 3:23-6. doi: 10.1046/j.1528-1157.2001.042suppl.3023.x. PMID: 11520318

Prognosis

Gupta J, Badal S, Anand V, Jauhari P, Chakrabarty B, Gulati S
Neurol India 2022 Jan-Feb;70(1):312-314. doi: 10.4103/0028-3886.338670. PMID: 35263902
Formeister EJ, Chae R, Wong E, Chiao W, Pasquesi L, Sharon JD
Ann Otol Rhinol Laryngol 2022 Apr;131(4):403-411. Epub 2021 Jun 13 doi: 10.1177/00034894211025416. PMID: 34121469
Menant JC, Meinrath D, Sturnieks DL, Hicks C, Lo J, Ratanapongleka M, Turner J, Migliaccio AA, Delbaere K, Titov N, Close JCT, Lord SR
J Am Med Dir Assoc 2020 Mar;21(3):344-350.e2. Epub 2019 Oct 17 doi: 10.1016/j.jamda.2019.08.016. PMID: 31631029
Gunawardane PTK, Grossman A
Adv Exp Med Biol 2017;956:239-259. doi: 10.1007/5584_2016_76. PMID: 27888488
Reilly C, Menlove L, Fenton V, Das KB
Epilepsia 2013 Oct;54(10):1715-24. Epub 2013 Aug 14 doi: 10.1111/epi.12336. PMID: 23944981

Clinical prediction guides

Nasrullah N, Kerr WT, Stern JM, Wang Y, Tatekawa H, Lee JK, Karimi AH, Sreenivasan SS, Engel J Jr, Eliashiv DE, Feusner JD, Salamon N, Savic I
Epilepsy Behav 2023 Aug;145:109278. Epub 2023 Jun 23 doi: 10.1016/j.yebeh.2023.109278. PMID: 37356226
Formeister EJ, Chae R, Wong E, Chiao W, Pasquesi L, Sharon JD
Ann Otol Rhinol Laryngol 2022 Apr;131(4):403-411. Epub 2021 Jun 13 doi: 10.1177/00034894211025416. PMID: 34121469
Tian WT, Huang XJ, Liu XL, Shen JY, Liang GL, Zhu CX, Tang WG, Chen SD, Song YY, Cao L
Chin Med J (Engl) 2017 Sep 5;130(17):2088-2094. doi: 10.4103/0366-6999.213431. PMID: 28836553Free PMC Article
Gunawardane PTK, Grossman A
Adv Exp Med Biol 2017;956:239-259. doi: 10.1007/5584_2016_76. PMID: 27888488
Reilly C, Menlove L, Fenton V, Das KB
Epilepsia 2013 Oct;54(10):1715-24. Epub 2013 Aug 14 doi: 10.1111/epi.12336. PMID: 23944981

Recent systematic reviews

Hassan A
Tremor Other Hyperkinet Mov (N Y) 2023;13:9. Epub 2023 Mar 28 doi: 10.5334/tohm.747. PMID: 37008993Free PMC Article

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