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EnglishAge of onset can have a significant impact on clinical course and pathophysiological mechanism of bipolar disorder. Late-onset bipolar episodes are more likely linked to medical illnesses and so are frequently classified as "secondary" forms of mood disorder. We discuss the case of a patient who at the age of 58 presented his first delusional-manic episode. He also had mild frontal and occipital cortical atrophy, white matter posterior ischemic lesions, and small basal ganglia calcifications. Seven years later, he presented a second manic episode with new emergent hyperkinetic choreiform symptoms. Taking into account movement disturbances, the presence of basal ganglia calcification, and worsening of cortical atrophy, we performed a differential diagnosis between Fahr disease, Fahr's syndrome, calcifications due to ageing, supersensitivity psychosis, and dementia. Valproate, quetiapine, and tetrabenazine were sequentially administered and yielded a good therapeutic response as regards manic and movement symptoms. Relationship between medications and course of specific symptoms was observed.
| Autori interni: | |
| Autori: | Roiter, Beatrice; Pigato, Giorgio; Perugi, Giulio |
| Titolo: | Late-Onset Mania in a Patient with Movement Disorder and Basal Ganglia Calcifications: A Challenge for Diagnosis and Treatment |
| Anno del prodotto: | 2016 |
| Digital Object Identifier (DOI): | 10.1155/2016/1393982 |
| Appare nelle tipologie: | 1.1 Articolo in rivista |
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