Clinical difficulties in post-stroke mania

Maria Do Céu Ferreira,Álvaro Machado,Célia Machado,Beatriz Santos

doi:10.1590/0101-60830000000074

Abstract

Clinical difficulties in post-stroke mania

Highlights

Dear Editor, A 52-year-old man presented to our outpatient psychiatry department due to elevated mood, reduced need of sleep, elevated energy, disinhibition and grandiose delusions during the last two months
No previous history of any psychiatric disorder, including mood or substance use disorders, could be evidenced. He was medicated with levetiracetam for the seizures
It was decided to change the antiepileptic drug and the patient stopped levetiracetam and started lamotrigine, without psychiatric improvement. He started quetiapine up 400 mg/day and after olanzapine up 20 mg/day was associated, both without psychiatry improvement

Summary

Introduction

1 Hospital de Braga, Psychiatry Department, Braga, Portugal. Dear Editor, A 52-year-old man presented to our outpatient psychiatry department due to elevated mood, reduced need of sleep, elevated energy, disinhibition and grandiose delusions during the last two months. He had a left lenticulo-capsular hematoma and underwent decompressive craniectomy two years before the onset of psychiatric symptoms. The patient presented sequelae of right hemiparesis, motor aphasia and late-onset seizures, without evidence of cognitive impairment (normal Mini Mental State Examination score).

Results

Conclusion