Late Mania: Case Report

Abstract

Introduction : Bipolar disorders are frequent troubles touching 1 to 2% of the general population. The average age of disease onset is between 20 and 25 years. While the early onset is predictive of a more severe disorder, the late start, with elderly people, raises the problem of the frequency of secondary mania. Methodology Presentation of a clinical case and use of a bibliography from the following search engines: PubMed, Science direct, Medscape. Key words Bipolar disorder, mania, elderly person. Case report This case is about a 62-year-old woman, hypertensive and obese, who had a gastric by-pass complicated by deficiency neuropathy and Gayet Wernicke’s encephalopathy. While neurological symptoms were improved by treatment with B1 and B12 vitamins, carbamazepine and clomipramine, a state of psychomotor excitation persisted and prompted a psychiatric consultation. The diagnosis of a maniac episode was retained and the patient was put under mood stabilizer treatment. Discussion Etiological research discussed three cases: A mania induced by Vitamin B12 deficiency, associated to neurological symptoms with impaired memory, paresthesia, and ataxia. A mania induced by treatment with clomipramine. A primary mania in an obese woman. This possibility is not uncommon. Indeed, several studies have confirmed the frequency of comorbidity of mood disorders and obesity.