In 1871, Westphal 1 coined the term “agoraphobia” to describe a syndrome characterized by vertigo, anxiety and palpitations associated with fear of venturing into wide-open spaces and crowded places, such as squares, churches or theatres. In Westphal’s opinion, anxiety represented the “core” of this disorder and therefore he diverged basically from his coeval Benedikt 2 who, one year earlier, had described similar cases indicating “vertigo” as the central element of the disorder and interpreting it as a consequence of a dysfunction of the ocular muscles. Since then, until today, in spite of the reassuring identity between Westphal’s and modern authors’ descriptions, the definition of agoraphobia as a primary syndrome and its nosological classification have come under a lively debate, not yet concluded, in particular as regards its relationship with panic disorder. The purpose of this manuscript is to undertake a rereading of agoraphobia, dismantling it on its peculiar aspects to analyze them in the light of the current neurobiological knowledge and the main theories of emotions. Not only clinical studies, focusing on the relationship between agoraphobia and panic disorder, but also the current knowledge about the fear system and the main theories of emotions, especially teleosemantics, lead to hypothesize the existence of a primary form of agoraphobia with its own specific symptomatology.
