What Causes Panic Attacks Along With Disorientation?

a friend of mine (high functioning male, 19) has following: sudden onset of panic attacks in previously relaxed individual, no clear triggers/precipitating factors, attacks characterised by increased heart rate, rapid breathing, general feeling of being unwell, confusion, disorientation and shaking - shaking is not tremor but rather atypical - a waving or repeated handshake type movement. Attacks last anywhere from 15-40 mins and result in several hours of exhaustion, confused/unclear thinking. Abnormal bloods: glucose 109 chloride 108 Ast/sgot 46