Manic Episodes Possibly Secondary to Pediatric Ischemic Stroke

可能次發於幼童型中風之躁症

10.29478/TJP.201112.0009

洪曉琪(Hsiao-Chi Hung)；林承儒(Chen-Ju Lin)；黃郁心(Yu-Hsin Huang)

secondary mania ； stroke ； left frontal lesion ； pediatric condition

台灣精神醫學

25卷4期（2011 / 12 / 01）

287 - 290

英文

Background: Post-stroke mania has rarely been reported, and the lesions of most reported cases have been involved in the non-dominant hemisphere of the brain. We reported a case of mania probably secondary to stroke with a lesion in the dominant hemisphere. Case Report: A 22-year-old, right-handed male patient had a history of pediatric stroke involved in the left middle cerebral artery territory of the brain. He became depressed right after the stroke, and five years later he developed a manic episode. He received lithium and risperidone with satisfactory response. Conclusion: The brain lesion other than laterality may play an important role on the etiology of mania. The research on secondary mania after the stroke is needed to explore the relationship between mood and brain functional region.

1. Chemerinski, M. E.,Levine, S. R.(2006).Neuropsychiatric disorders following vascular brain injury.Mt Sinai J Med,73,1006-14.
2. Evans, D. L.,Byerly, M. J.,Greer, R. A.(1995).Secondary mania: diagnosis and treatment.J Clin Psychiatry,56(Suppl 3),31-7.
3. Fenn, D.,George, K.(1999).Post-stroke mania late in life involving the left hemisphere.Aust N Z J Psychiatry,33,598-600.
4. Liu, C. Y.,Wang, S. J.,Fuh, J. L.,Yang, Y. Y.,Liu, H. C.(1996).Bipolar disorder following a stroke involving the left hemisphere.Aust N Z J Psychiatry,30,688-91.
5. Mimura, M.,Nakagome, K.,Hirashima, N.,Ishiwata, H.,Kamijima, K.,Shinozuka, A.(2005).Left frontotemporal hyperperfusion in a patient with post-stroke mania.Psychiatry Res,139,263-7.
6. Morris, P. L.,Robinson, R. G.,Raphael, B.,Hopwood, M. J.(1996).Lesion location and poststroke depression.J Neuropsychiatry Clin Neurosci,8,399-403.
7. Robinson, R. G.(1997).Mood disorders secondary to stroke.Semin Clin Neuropsychiatry,2,244-51.
8. Robinson, R. G.,Boston, J. D.,Starkstein, S. E.,Price, T. R.(1988).Comparison of mania and depression after brain injury: causal factors.Am J Psychiatry,145,172-8.
9. Starkstein, S. E.,Boston, J. D.,Robinson, R. G.(1988).Mechanisms of mania after brain injury. 12 case reports and review of the literature.J Nerv Ment Dis,176,87-100.
10. Starkstein, S. E.,Robinson, R. G.(1997).Mechanism of disinhibition after brain lesions.J Nerv Ment Dis,185,108-14.
11. Steffens, D. C.,Krishnan, K. R.(1998).Structural neuroimaging and mood disorders: recent fi ndings, implications for classifi cation, and future directions.Biol Psychiatry,43,705-12.