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Mania following left hemisphere injury
1Department of Psychological Medicine National University Hospital, Singapore.
Abstract:
A case of mania following closed head injury to the left hemisphere is reported. The patient presented with a self-limiting manic episode that recovered without treatment. It is postulated that the head injury is the causative factor in this case. This was supported by laboratory results as well as psychological investigations. It is believed that non-dominant right hemisphere injury is related to the development of mania. However, a search of the literature revealed five other cases of mania following left hemispheric injury. Although the mechanisms implicated in the pathogenesis of secondary mania have not been established, this case adds to the growing evidence that head injury may be directly causative in affective psychoses. Therefore, it is premature to conclude that mania is a pathology of the non-dominant right hemisphere.
Insights
Head injuries can trigger mania, even when affecting the left brain hemisphere. This case suggests head trauma may directly cause affective disorders, challenging previous assumptions about brain lateralization in mania.
Area of Science:
- Neuroscience
- Psychiatry
- Neurology
Background:
- Secondary mania, or mania developing after a neurological event, is not fully understood.
- Previous theories suggested a link between mania and non-dominant (right) hemisphere brain injury.
Observation:
- A patient experienced a self-limiting manic episode after a closed head injury to the left cerebral hemisphere.
- Laboratory and psychological investigations supported the head injury as the causative factor.
Findings:
- Despite the left hemisphere injury, the patient's mania resolved spontaneously without intervention.
- A literature review identified five prior cases of mania linked to left hemispheric injury.
Implications:
- This case contributes to evidence suggesting head trauma can directly cause affective psychoses.
- It challenges the established notion that mania is exclusively associated with non-dominant right hemisphere pathology.