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Secondary mania after ventral pontine infarction
M E Drake1, A Pakalnis, B Phillips
1Department of Neurology, Ohio State University Hospitals and College of Medicine, Columbus.
The Journal of Neuropsychiatry and Clinical Neurosciences
|January 1, 1990
Summary
Secondary mania, a condition with manic symptoms and no prior history, can be linked to brain disease. Pontine infarction may cause late-onset mania, which can be treated with medication.
Area of Science:
- Neurology
- Psychiatry
Background:
- Secondary mania presents with manic symptoms in individuals without a prior history of affective disorder.
- It has been associated with various neurological conditions including tumors, epilepsy, and cerebrovascular events.
Observation:
- Two middle-aged men with no psychiatric history developed symptoms of mania, including grandiosity, sleeplessness, and delusions.
- Neurological examinations revealed mild hemiparesis in one patient; both had normal electrophysiological tests.
- Magnetic resonance imaging (MRI) identified ventral pons infarction in both patients.
Findings:
- Ventral pons infarction was correlated with the onset of secondary mania in these two cases.
- Treatment with lithium carbonate and neuroleptics led to symptom resolution and sustained remission over 18 months.
Implications:
- These findings highlight the association between late-onset mania and underlying brain disease, specifically brainstem lesions.
- Disturbances in the brainstem may play a role in regulating mood, sleep, and cognitive functions.
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