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Mania in neurologic disorders
1Neurobehavior Unit (116AF), Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. MMendez@ucla.edu
Abstract:
Neurologic disorders can produce "secondary" mania. Clinicians must distinguish secondary mania from primary, idiopathic manic-depressive illness (MBI). In addition to medical and drug-induced causes of secondary mania, neurologic causes usually develop in older patients who may lack a strong family history of MDI. Neurologic causes of mania include focal strokes in the right basotemporal or inferofrontal region, strokes or tumors in the perihypothalamic region, Huntington's disease and other movement disorders, multiple sclerosis and other white matter diseases, head trauma, infections such as neurosyphilis and Creutzfeldt-Jakob disease, and frontotemporal dementia. Patients with new-onset mania require an evaluation that includes a thorough history, a neurologic examination, neuroimaging, and other selected tests. The management of patients with neurologic mania involving correcting the underlying disorder when possible and the judicious use of drugs such as the anticonvulsant medications.
Insights
Secondary mania can arise from neurologic disorders, distinct from primary manic-depressive illness (MDI). Prompt evaluation, including neuroimaging, is crucial for diagnosing and managing these cases.
Area of Science:
- Neurology
- Psychiatry
Background:
- Neurologic disorders can manifest as secondary mania, mimicking primary manic-depressive illness (MDI).
- Distinguishing secondary mania is critical for appropriate patient management.
- Neurologic causes are more common in older patients without a family history of MDI.
Purpose of the Study:
- To highlight the importance of identifying neurologic causes of secondary mania.
- To outline the diagnostic evaluation for patients presenting with new-onset mania.
- To discuss management strategies for neurologic mania.
Main Methods:
- Review of clinical presentations and diagnostic criteria for secondary mania.
- Emphasis on thorough patient history and neurological examination.
- Inclusion of neuroimaging and other selected tests for diagnosis.
Main Results:
- Identified various neurologic conditions associated with secondary mania, including strokes, tumors, movement disorders, white matter diseases, trauma, infections, and dementia.
- Stressed the need for a comprehensive evaluation to differentiate secondary from primary mania.
- Highlighted the potential for treating the underlying neurologic disorder.
Conclusions:
- New-onset mania necessitates a thorough evaluation to rule out underlying neurologic causes.
- Early diagnosis and management of neurologic mania can improve patient outcomes.
- Treatment involves addressing the primary neurologic condition and utilizing medications like anticonvulsants.