Mania following head trauma

American Journal of Psychiatry (Impact Factor: 12.3). 02/1987; 144(1):93-6.
Source: PubMed


The authors present psychiatric and neurologic data on 20 patients who developed mania after closed head trauma. An association was seen between severity of head trauma (based on length of posttraumatic amnesia), posttraumatic seizure disorder, and type of bipolar disorder. The manic episodes were characterized by irritable mood rather than euphoria and by assaultiveness. Psychosis occurred in only 15% of the sample, and 70% had no depressive episodes. Bipolar disorders were absent among 85 first-degree relatives. The authors suggest that posttraumatic seizures may be a predisposing factor in posttraumatic mania.

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    • "These authors found a significant association between mania and the presence of post-traumatic seizures , predominantly of the partial complex type (temporal lobe epilepsy). There was no association, however, with family history of bipolar disorder among first-degree relatives (Shukla et al., 1987). We have previously reported that six out of 66 TBI patients (9%) developed manic or mixed episodes at some point during the first year following TBI. "
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    ABSTRACT: Mood disturbances, especially depressive disorders, are the most frequent neuropsychiatric complication of traumatic brain injury (TBI). These disorders have a complex clinical presentation and are highly comorbid with anxiety, substance misuse, and other behavioral alterations such as impulsivity and aggression. Furthermore, once developed, mood disorders tend to have a chronic and refractory course. Thus, the functional repercussion of these disorders is huge, affecting the rehabilitation process and the long-term outcome of TBI patients. The pathophysiology of mood disorders involves the interplay of factors that precede trauma (e.g., genetic vulnerability and previous psychiatric history), factors that pertain to the traumatic injury itself (e.g., type, extent, and location of brain damage) and factors that influence the recovery process (e.g., family and social support). It is hardly surprising that mood disorders are associated with structural and functional changes of neural circuits linking brain areas specialized in emotional processing such as the prefrontal cortex, basal ganglia, and amygdala. In turn, the onset of mood disorders may contribute to further prefrontal dysfunction among TBI patients. Finally, in spite of the prevalence and impact of these disorders, there have been relatively few rigorous studies of therapeutic options. Development of treatment strategies constitutes a priority in this field of research. © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Feb 2015 · Handbook of Clinical Neurology
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    • "Association to trauma severity, cognitive impairment and seizures was not found. However, another study related mania after TBI to seizures (Shukla et al 1987). A case report by Murai and Fujimoto (2003) described a patient who developed rapid cycling bipolar symptoms after a circumscribed lesion in the left temporal pole due to TBI. "
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    ABSTRACT: Psychiatric disorders after traumatic brain injury (TBI) are frequent. Researches in this area are important for the patients' care and they may provide hints for the comprehension of primary psychiatric disorders. Here we approach epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI. Finally, the present situation of the knowledge in this field is discussed.
    Full-text · Article · Sep 2008 · Neuropsychiatric Disease and Treatment
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    ABSTRACT: A young, black, adult woman presented to an outpatient clinic for treatment with a history of intermittent, nonschizophrenic, psychotic symptoms. Blacks, because of their situational sociology, may be more predisposed to severe head injuries, and this acquired biologic factor may be, in part, responsible for the high rates of black-on-black murder. The use of beta blockers is discussed as an adjunct in the treatment of violence occurring in patients with a past history of severe head injury.
    Full-text · Article · Dec 1987 · Journal of the National Medical Association
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