Which CNS symptom cluster can occur with acute intermittent porphyria?

Which CNS symptom cluster can occur with acute intermittent porphyria?

• A. Anxiety and confusion only
• B. Anxiety, confusion, seizures, psychosis, coma
• C. Euphoria
• D. Memory loss only

Answer: (B)

Acute intermittent porphyria can cause neuropsychiatric symptoms because porphyrin precursors accumulate in the nervous system during an acute attack, leading to CNS hyperexcitability and mental status changes. The CNS manifestations span a broad spectrum from anxiety and agitation to confusion, seizures, psychosis, and can progress to coma if the crisis worsens. This wide range is typical of an acute porphyric crisis, reflecting the neurotoxic effects of accumulated precursors. The other options describe only isolated or narrower symptoms (like memory loss or euphoria) and don’t capture the full CNS involvement seen in these attacks.

Acute intermittent porphyria can cause neuropsychiatric symptoms because porphyrin precursors accumulate in the nervous system during an acute attack, leading to CNS hyperexcitability and mental status changes. The CNS manifestations span a broad spectrum from anxiety and agitation to confusion, seizures, psychosis, and can progress to coma if the crisis worsens. This wide range is typical of an acute porphyric crisis, reflecting the neurotoxic effects of accumulated precursors. The other options describe only isolated or narrower symptoms (like memory loss or euphoria) and don’t capture the full CNS involvement seen in these attacks.