Louise Thomas, 43, from Cheam, was convinced she was suffering panic attacks . Panic attacks are extremely common, with one in ten of us thought to suffer from them at least occasionally. Louise Thomas - and her doctors - were convinced she was one of the millions affected. A panic attack typically causes a faster heartbeat, dizziness, nausea and an overwhelming sense of anxiety. Mother-of-two Louise had experienced such episodes regularly for seven years. 'In my early 30s, I started having episodes of feeling very nervous and anxious, with butterflies in my stomach and a feeling of being on edge,' says the 43-year-old. 'This could last all day. Sometimes, I wouldn't know where the last 30 seconds had gone and would feel confused, but still nervous and agitated, wondering what had just happened.' She was prescribed antidepressants and tried talking therapies, but nothing helped. That's because Louise, from Cheam, Surrey, wasn't suffering from panic attacks at all, but epileptic seizures. Her problems were neurological rather than psychological. And her story is not uncommon. As Paul Salkovskis, professor of clinical psychology at the University of Bath, explains, the symptoms of a panic attack can overlap with an epileptic seizure. 'It's not unusual for people with panic attacks to get an incorrect preliminary diagnosis of epilepsy, and occasionally, people with epilepsy get a misdiagnosis of panic attacks. If they see a specialist, it is usually clarified,' he says. Unfortunately, Louise didn't see a specialist for years. So how can the conditions be confused? Epilepsy, which affects more than 600,000 people in the UK, is characterised by recurrent seizures or sudden bursts of intense, abnormal electrical activity in the brain that disrupt the way it works. But there are many kinds of epileptic seizure. Dr Hannah Cock, consultant neurologist at St George's Hospital, London, and the University of London, says: 'The bit of the brain where the seizure starts and the path where the electrical discharge then spreads can vary enormously between individuals - which is why there are so many different ways people can experience an epileptic seizure.' One such example is with gelastic seizures - where patients may burst out laughing for no apparent reason, because the part of the brain involved in the seizure is also involved in laughter. Other seizures may involve a feeling of deja vu, which can make diagnosis difficult, since this is 'a normal phenomenon that we all sometimes experience', says Dr Cock, who is also clinical adviser to the charity Epilepsy Action. 'As the experience is so recurrent and frequent, it usually becomes clear that something else is going on,' she says. 'Or if the laughing attack is followed by losing consciousness and having a convulsion, diagnosis is easier.' Louise struggled to understand what was happening for seven years after her first episode . But a further complication is that seizures may cause someone to panic, adds Professor Salkovskis. 'It's perfectly possible that people with epilepsy will get panicky at the prospect of having a seizure. And in panic attacks, people hyperventilate, which can trigger an epileptic attack in people who are vulnerable to it.' One key differences between them is that while a seizure can lead to loss of consciousness, a panic attack usually won't, he says. But diagnosis can be hard, as there's no definitive test for epilepsy. An MRI scan can identify possible causes such as scarring on the brain, while an electroencephalogram, where electrodes are attached to the scalp, can help detect unusual brain activity associated with epilepsy. But this can also be normal in people with epilepsy, or show minor changes in people without. After her first episode, Louise looked up her symptoms online, which suggested she'd had a panic attack. Her GP suggested it was a delayed reaction to an incident a couple of years earlier, when she found an intruder breaking in to her house. 'This seemed to make sense. I'd been a quivering wreck at the time. I was a busy mum with two young kids, so I was a bit stressed.' The next seven years were fraught as Louise struggled to understand what was happening. She became a 'nervous wreck'. 'I went back and forth to the doctor's - I must have seen ten GPs in total - but, each time, I was told it sounded like panic attacks or depression. 'I remember the terms "post-traumatic disorder" and "generalised anxiety disorder" were also used. But there was never further investigation. I was given antidepressants and, one time, a Valium-type drug to calm me down.' But the drugs didn't work, and Louise would stop taking them after a few months. Husband Vincent took Louise to the GP and explained the attacks from his perspective - and her episodes were finally diagnosed corretly . 'I was just told to take them again. I even tried cognitive behaviour therapy online and had requested counselling, but nothing helped,' she says. 'This just fuelled my stress. I became a stroppy, emotional rollercoaster. My poor husband, Vincent, had to cope with me just going through the motions.' Meanwhile, her 'panic attacks' were getting worse: she was having five a day and experiencing urinary incontinence when they occurred. 'A few times, I fell down the stairs and was badly bruised; other times, I burnt myself on the oven and the iron. I even drove into a tree with both children in the car. Fortunately, I was going slowly, but it was terrifying. At that point, I knew something was really wrong.' In 2011, seven years after the panic attacks began, Vincent took Louise to the GP and explained the attacks from his perspective. 'He said that when I had an attack, I'd involuntarily raise my arm and start tutting. I wasn't even aware of this. But despite it sounding so odd, the GP still seemed to think this could tie in with a panic attack, so we decided to see a neurologist privately for a second opinion.' The specialist diagnosed Louise with temporal lobe epilepsy, a common type affecting the part of the brain concerned with emotion and hearing, as well as language and memory. The cause, in her case, was unknown, although brain tumours, head injuries, brain infections and strokes can all cause epilepsy. Dr Cock says: 'In temporal lobe seizures, common warning signs are feelings of intense anxiety, fear and panic, so these are ones more likely to be misdiagnosed as panic attacks. Structures in and close to the temporal lobe may also cause the heart to race and the sweating that may go along with it. 'Other signs may include deja vu and some experience "gastric rising" - that feeling in the stomach when you go over a humpback bridge. 'During the seizure, the patient may look blank and be completely amnesiac through the episode, losing a bit of time.' People with epilepsy may also have involuntary facial or hand movements, as Louise did, which indicate the electrical discharge has spread to an area of the brain involved in movement. Epilepsy does not tend to worsen over time but, if left untreated, the continued, unexplained seizures can fuel further anxiety, which may make the seizures worse. 'Generally, if people are not diagnosed, that causes anxiety and depression and increases stress levels, which may make seizures more frequent and more serious,' says Dr Cock. 'Whether stress itself causes seizures is controversial, but it's likely that, in some individuals, it may be a trigger - perhaps because stress leads to other triggers, such as alcohol and sleep deprivation.' Louise was relieved to finally find out what was wrong with her - but the diagnosis was frightening. 'It never occurred to me that I might have epilepsy. Being told was like being told I was going to die. 'The thought of all the seizures I'd had in public - on buses, at school meetings - was humiliating.' It took several months for Louise's psychological and neurological symptoms to become untangled. Even after being diagnosed with epilepsy, one neurologist thought she was experiencing non-epileptic seizures as well - seizures that are believed to have a psychological basis and are not caused by disrupted electrical brain activity. These seizures account for up to 30 per cent of people referred to epilepsy clinics. After her diagnosis, Louise was given antidepressants - which can sometimes help with non-epileptic seizures - along with anti-epileptic medication, which works by changing levels of chemicals in the brain that conduct electrical impulses. 'The side-effects of these drugs were horrible. It was like a 24-hour hangover,' she says. 'And I was still having seizures.' Because of the seizures, she had to give up her driving licence. However, things started to look up when, in 2012, she was referred to Dr Cock. Her medication was switched to lamotrigine - a different anti-epileptic drug. And two years ago, the seizures stopped. 'It was a huge relief,' says Louise. 'I could still have one tomorrow, but I used to dread waking up in the morning. Now I can live a normal life again.' Visit Epilepsy Action at epilepsy.org.uk and epilepsysociety.org.uk .
Louise Thomas, 43, from Cheam, thought she was suffering panic attacks . Mother-of-two was prescribed antidepressants and tried talking therapies . Nothing helped because she was actually suffering from epileptic seizures .