title: Ultra-rapid cycling bipolar affective disorder following a closed-head injury.
abstract: A young adult with no prior history of affective disease suffered the onset of a rapid cycling bipolar illness, marginally responsive to psychotropic medications, following a mild closed-head injury, and persisting after the cognitive effects of the injury had resolved. A concurrence of findings on the neurological examination, neurobehavioural examination, SPECT scan, EEG and neuropsychological test battery suggested the presence of a diffuse cerebral injury with a predominance of left frontotemporal findings. This case demonstrates that a severe and disabling mood disorder may follow a mild head injury, and that its course may be independent of cognitive impairment and recovery.
authors.affiliation: Department of Psychiatry and Human Behavior, Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: A S
authors.initials: AS
authors.lastname: Zwil
authors.forename: T W
authors.initials: TW
authors.lastname: McAllister
authors.forename: I
authors.initials: I
authors.lastname: Cohen
authors.forename: L R
authors.initials: LR
authors.lastname: Halpern
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D001925:Brain Damage, Chronic / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D002220:Carbamazepine / Q000627:therapeutic use; D004292:Dominance, Cerebral / Q000502:physiology; D004359:Drug Therapy, Combination; D005625:Frontal Lobe / Q000293:injuries / Q000503:physiopathology; D006220:Haloperidol / Q000627:therapeutic use; D016489:Head Injuries, Closed / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D019965:Neurocognitive Disorders / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D009483:Neuropsychological Tests; D010507:Periodicity; D013702:Temporal Lobe / Q000293:injuries / Q000503:physiopathology
chemical_list: D014150:Antipsychotic Agents; D016651:Lithium Carbonate; D002220:Carbamazepine; D006220:Haloperidol; D007099:Imipramine