Acute mania and hemichorea.
A 61-year-old man suddenly became euphoric and talkative. Later the same day, he developed hemichoreic movements of the left limbs. The patient fulfilled the DSM-IV criteria for a manic episode by abnormally and persistently elevated mood, decreased need for sleep, high distractibility, pressured speech, increased goal-directed activity, and hypersexuality. The mood changes persisted for several weeks. Magnetic resonance imaging of the brain showed a right thalamic infarction. The co-occurrence of hemichorea and mania caused by focal thalamic lesion is very rare. It may be explained by dysfunction in basal ganglia thalamocortical circuitry.
Inzelberg
R
R
Department of Neurology, Hillel Yaffe Medical Center, Hadera, Israel.
Nisipeanu
P
P
Joel
D
D
Sarkantyus
M
M
Carasso
R L
RL
D000208:Acute Disease; D001714:Bipolar Disorder / Q000175:diagnosis*; D002819:Chorea / Q000175:diagnosis*; D005059:Euphoria; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013788:Thalamus / Q000473:pathology