scholarly journals Neuroleptic Malignant Syndrome in an Elderly Patient with Bipolar Disorder

2021 ◽  
Vol 16 (2) ◽  
pp. 280-286
Author(s):  
Luke Sy-Cherng Woon ◽  
Keyword(s):  
Bipolar Disorder ◽  
Neuroleptic Malignant Syndrome ◽  
Sodium Valproate ◽  
Extended Release ◽  
Manic Episode ◽  
Electrolyte Imbalance ◽  
Chronic Obstructive ◽  
Muscle Rigidity ◽  
Typical Antipsychotic ◽  
Contributing Factors

Neuroleptic malignant syndrome (NMS) is a well-known and potentially fatal complication of antipsychotic use. The elderly population, with multiple risk factors, are more vulnerable to this condition. We described a case of an 80-yearold man with bipolar disorder, previously on oral extended-release sodium valproate, aripiprazole and long-acting injectable paliperidone, who developed NMS. He presented with generalised muscle rigidity, fever, fluctuating blood pressure and elevated creatinine kinase during his hospitalisation for a manic episode. Contributing factors included old age, underlying vascular Parkinsonism, electrolyte imbalance, intercurrent lung infection with acute exacerbation of chronic obstructive pulmonary disease, hyperactive delirium, and repeated administration of parenteral typical antipsychotic. Antipsychotics were withheld promptly, and the patient was treated with dantrolene, bromocriptine and amantadine. His symptoms resolved after a week. He subsequently remained well with oral extended-release sodium valproate alone. Relevant clinical points are discussed. Clinical vigilance, close interdisciplinary cooperation, and prompt interventions are keys to successful to management of NMS in elderly patients.

scholarly journals Cognitive flexibility and problem-solving in patients with bipolar disorder

2019 ◽  
Vol 2 (2) ◽  
pp. 63
Author(s):  
Maria Yosepha Safira Nugroho ◽  
B. Handoko Daeng ◽  
Gladdy L. Waworuntu
Keyword(s):  
Bipolar Disorder ◽  
Problem Solving ◽  
Cognitive Flexibility ◽  
Manic Episode ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Mixed Episode ◽  
Sorting Test

Introduction: This study focuses on the cognitive impairment in patients with bipolar disorder and also the distribution of cognitive flexibility and problem-solving by degree of education, chronicity, and episode of patient is in at the time of evaluation.Methods: This was a cross sectional descriptive study with purposive sampling method. The population was the Harmony in Diversity Group in Surabaya, Indonesia. Twenty-two patients agreed to be subjects and each of them finished the Wisconsin Card Sorting Test (WCST) to measure cognitive flexibility and the Tower of London (TOL) to measure problem-solving. Results: The WCST score are below normal for 90.9% of the patients. Higher cognitive flexibility is found in patients with bachelor’s degree and euthymic patients, while lower cognitive flexibility is found in patients in depression episode, manic episode, and mixed episode. No patients could finish the TOL within the minimum required steps. Better problem-solving is found in patients in manic episode and euthymic patients while lower problem-solving is found in mixed episode and depressive episode.Conclusion: The cognitive flexibility and problem-solving in patients with bipolar disorder are lower than the normal cut off. The type of episode and chronicity are contributing factors. Euthymic patients tend to have better cognitive flexibility and manic patients tend to have better problem-solving ability.

P01-228-Behcet's syndrome comorbid with bipolar disorder: A case report

2011 ◽  
Vol 26 (S2) ◽  
pp. 229-229
Author(s):  
F. Maner ◽  
Ö. Şahmelikoğlu ◽  
Ö. Hısım ◽  
H. Özhan ◽  
H. Sarıahmetoğlu ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Manic Episode ◽  
Unknown Etiology ◽  
Inflammatory Disorder ◽  
Behçet’S Syndrome ◽  
Psychomotor Activity ◽  
Chronic Inflammatory Disorder ◽  
Behçet's Syndrome ◽  
Behcet’S Syndrome ◽  
Behcet's Syndrome

IntroductionBehcet's Syndrome is a chronic inflammatory disorder of unknown etiology, characterized by aphthous lesions and recurrent ulceration of the mouth, genitals and uveitis.ObjectivesThe central nervous system is involved in about 20% of cases.AimsOnly few reports deal with affective symptoms associated with Behcet's syndrome.MethodsWe report a case of a 43 year old male with Neuro-Behcet's Syndrome that presents with a psychotic manic attack. He developed Behcet's Syndrome at the age of 23, with recurrent uveitis and aphthous lesions in the mouth, painful ulcers in the genitalia and erythema nodosum. HLA-B 5 was positive.ResultsHe was treated with azothioprine 150 mg/day for 13 years and prednole 100 mg/day during uveitis attacts for a week. At the age of 37 a sudden occurrence of right hemiparesia due to cerebrovascular accidence salicylic acid 100mg/day, siclosporine 150 mg/day, piracetame 1600mg/day were administered. He presented to psychiatry clinic in manic episode with euphoric mood, psychomotor agitation, talkativeness, decreased need for sleep, excessive buying and he had an unrealistical thought that he was a player of a famous soccer team. He was diagnosed as bipolar I disorder, according to DSM-IV. This was the patient's first admission and the symptoms which were continuing for 6 years exaggerated during uveitis attacks.Psychiatric examination releaved that increaced psychomotor activity, hypomaniac affect, amount and affect speed of speech affect, increased associations, grandiose delusions.ConclusionThere are a few reports dealing with bipolar disorder as an entity related to Behcet's syndrome.

Baseline and prodromal characteristics of first- versus multiple-episode mania in a French cohort of bipolar patients

2011 ◽  
Vol 27 (8) ◽  
pp. 557-562 ◽  
Author(s):  
J.-M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
E. Hantouche ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Correct Diagnosis ◽  
Manic Episode ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Prodromal Phase ◽  
Multiple Episode ◽  
Patients At Risk ◽  
Bipolar Patients

AbstractObjective:To identify some of the main features of bipolar disorder for both first-episode (FE) mania and the preceding prodromal phase, in order to increase earlier recognition.Methods:One thousand and ninety manic patients (FE=81, multiple-episodes [ME]=1009) were assessed for clinical and temperamental characteristics.Results:Compared to ME, FE patients reported more psychotic and less depressive symptoms but were comparable with respect to temperamental measures and comorbid anxiety. The following independent variables were associated with FE mania: a shorter delay before correct diagnosis, greater substance use, being not divorced, greater stressors before current mania, a prior diagnosis of an anxiety disorder, lower levels of depression during index manic episode, and more suicide attempts in the past year.Conclusion:In FE patients, the diagnosis of mania may be overlooked, as they present with more psychotic symptoms than ME patients. The prodromal phase is characterised by high levels of stress, suicide attempts, anxiety disorders and alcohol or substance abuse. Data suggest to consider these prodromes as harmful consequences of temperamental predispositions to bipolar disorder that may concur to precipitate mania onset. Their occurrence should therefore incite clinicians to screen for the presence of such predispositions, in order to identify patients at risk of FE mania.

Bipolar Disorder: Manic Episode

2004 ◽  
Vol 16 (4) ◽  
pp. 300-301 ◽  
Author(s):  
Marshelle Thobaben ◽  
Stephanie Wehr
Keyword(s):  
Bipolar Disorder ◽  
Manic Episode

Obsessive–compulsive disorder in bipolar disorder patients with first manic episode

2006 ◽  
Vol 94 (1-3) ◽  
pp. 151-156 ◽  
Author(s):  
A PASHINIAN ◽  
S FARAGIAN ◽  
A LEVI ◽  
M YEGHIYAN ◽  
K GASPARYAN ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Obsessive Compulsive Disorder ◽  
Manic Episode ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Neurocysticercosis presenting as bipolar disorder: a case report

2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Depressive Symptoms ◽  
Affective Disorder ◽  
Postpartum Period ◽  
Bipolar Affective Disorder ◽  
Taenia Solium ◽  
Manic Episode ◽  
Symptoms And Signs ◽  
Rule Out

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

Brain oscillatory responses in patients with bipolar disorder manic episode before and after valproate treatment

2008 ◽  
Vol 1235 ◽  
pp. 98-108 ◽  
Author(s):  
Ayşegül Özerdem ◽  
Bahar Güntekin ◽  
Zeliha Tunca ◽  
Erol Başar
Keyword(s):  
Bipolar Disorder ◽  
Manic Episode ◽  
Before And After
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