CADASIL presenting as late-onset mania with anosognosia

Area of Science:

• Neurology
• Genetics
• Neuropsychology

Background:

• Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare genetic disorder.
• It affects small blood vessels in the brain, leading to strokes and cognitive decline.

Observation:

• Late-onset personality change and mania can be presenting symptoms of CADASIL.
• These psychiatric manifestations may precede or coincide with typical neurological symptoms.

Findings:

• Neuropsychological deficits associated with CADASIL can mimic other psychiatric conditions.
• This diagnostic challenge complicates the timely identification and treatment of CADASIL.

Implications:

• Clinicians should consider CADASIL in the differential diagnosis of late-onset mania and personality disorders.
• Early recognition of CADASIL is crucial for appropriate management and potentially slowing disease progression.