Abstract
Despite the substantial literature on mood disorders in epilepsy, the majority of authors focused on depression with limited data on manic symptoms. Historically, this was due to the general impression that both psychomotor excitation and overt mania were rarely encountered in epilepsy. However, recent studies demonstrated that manic symptoms can be occasionally seen in the context of epilepsy, either as seizure-based phenomena or as treatment-emergent adverse events.
This chapter briefly describes the evolution of the concept of bipolar disorders and covers the main symptom clusters usually described in manic episodes. In the epilepsy setting, peri-ictal manic symptoms are described post-ictally and are often associated with psychotic symptoms. Inter-ictal manic symptoms are definitely rare. Specific clinical entities, such as the inter-ictal dysphoric disorder of epilepsy, present some overlaps with the more unstable form of rapid cycling bipolar type II patients, but main psychopathological features are different. Manic symptoms as treatment-emergent adverse events of antiepileptic drugs are anecdotally described as well as after epilepsy surgery. Finally, major treatment options for mania in patients with epilepsy and the use of lithium are discussed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Temkin N. The falling sickness. Baltimore: The John Hopkins Press; 1971.
Mula M, Schmitz B. Depression in epilepsy: mechanisms and therapeutic approach. Ther Adv Neurol Disord. 2009;2(5):337–44.
Kwan P, Sander JW. The natural history of epilepsy: an epidemiological view. J Neurol Neurosurg Psychiatry. 2004;75(10):1376–81.
Maj M, Pirozzi R, Magliano L, Bartoli L. Long-term outcome of lithium prophylaxis in bipolar disorder: a 5-year prospective study of 402 patients at a lithium clinic. Am J Psychiatry. 1998;155(1):30–5.
Angst J, Sellaro R. Historical perspectives and natural history of bipolar disorder. Biol Psychiatry. 2000;48(6):445–57.
Amann B, Grunze H. Neurochemical underpinnings in bipolar disorder and epilepsy. Epilepsia. 2005;46 Suppl 4:26–30.
Mazza M, Di Nicola M, Della Marca G, Janiri L, Bria P, Mazza S. Bipolar disorder and epilepsy: a bidirectional relation? Neurobiological underpinnings, current hypotheses, and future research directions. Neuroscientist: Rev J Bring Neurobiol Neurol Psychiatry. 2007;13(4):392–404.
Mula M, Marotta AE, Monaco F. Epilepsy and bipolar disorders. Expert Rev Neurother. 2010;10(1):13–23.
Sedler MJ. Falret’s discovery: the origin of the concept of bipolar affective illness. Translated by M. J. Sedler and Eric C. Dessain. Am J Psychiatry. 1983;140(9):1127–33.
Kraepelin E, Johnstone T. Lectures on clinical psychiatry (3rd rev ed/by Thomas Johnstone. ed. [S.l.]). Bailliere Tindall and Cox; 1912.
Akiskal HS, Bourgeois ML, Angst J, Post R, Moller H, Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord. 2000;59 Suppl 1:S5–30.
Judd LL, Akiskal HS. The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. J Affect Disord. 2003;73(1–2):123–31.
Hantouche EG, Angst J, Akiskal HS. Factor structure of hypomania: interrelationships with cyclothymia and the soft bipolar spectrum. J Affect Disord. 2003;73(1–2):39–47.
Akiskal HS, Hantouche EG, Allilaire JF. Bipolar II with and without cyclothymic temperament: “dark” and “sunny” expressions of soft bipolarity. J Affect Disord. 2003;73(1–2):49–57.
Cassano GB, Mula M, Rucci P, Miniati M, Frank E, Kupfer DJ, et al. The structure of lifetime manic-hypomanic spectrum. J Affect Disord. 2009;112(1–3):59–70.
Gowers WRS. Epilepsy, and other chronic convulsive diseases: their causes, symptoms & treatment. London: J & A Churchill; 1881. pp. xiv. 309.
Jackson JHD. On epilepsy; in answer to the question-What is the nature of the internal commotion which takes place during an epileptic paroxysm? Samuel Highley, London; 1850.
Bleuler E. Lehrbuch der Psychiatrie. Springer, Berlin; 1916. p. viii. 518.
Gaitatzis A, Trimble MR, Sander JW. The psychiatric comorbidity of epilepsy. Acta Neurol Scand. 2004;110(4):207–20.
Blanchet P, Frommer GP. Mood change preceding epileptic seizures. J Nerv Ment Dis. 1986;174(8):471–6.
Scaramelli A, Braga P, Avellanal A, Bogacz A, Camejo C, Rega I, et al. Prodromal symptoms in epileptic patients: clinical characterization of the pre-ictal phase. Seizure. 2009;18(4):246–50.
Mula M, Jauch R, Cavanna A, Gaus V, Kretz R, Collimedaglia L, et al. Interictal dysphoric disorder and periictal dysphoric symptoms in patients with epilepsy. Epilepsia. 2010;51(7):1139–45.
Mula M, Schmitz B, Jauch R, Cavanna A, Cantello R, Monaco F, et al. On the prevalence of bipolar disorder in epilepsy. Epilepsy Behav. 2008;13(4):658–61.
Guillem E, Plas J, Musa C, Notides C, Lepine JP, Chevalier JF. Ictal mania: a case report. Can J Psychiatry. 2000;45(5):493–4.
Rohr-Le Floch J, Gauthier G, Beaumanoir A. Confusional states of epileptic origin, value of emergency EEG. Rev Neurol (Paris). 1988;144(6–7):425–36.
Wieser HG. Temporal lobe or psychomotor status epilepticus. A case report. Electroencephalogr Clin Neurophysiol. 1980;48(5):558–72.
Trimble MR, Schmitz B. Forced normalization and alternative psychoses of epilepsy. Petersfield: Wrightson Biomedical Pub. Ltd.; 1998. xi, 235p p.
Flor-Henry P. Schizophrenic-like reactions and affective psychoses associated with temporal lobe epilepsy: etiological factors. Am J Psychiatry. 1969;126(3):400–4.
Gillig P, Sackellares JC, Greenberg HS. Right hemisphere partial complex seizures: mania, hallucinations, and speech disturbances during ictal events. Epilepsia. 1988;29(1):26–9.
Nishida T, Kudo T, Inoue Y, Nakamura F, Yoshimura M, Matsuda K, et al. Postictal mania versus postictal psychosis: differences in clinical features, epileptogenic zone, and brain functional changes during postictal period. Epilepsia. 2006;47(12):2104–14.
Kanner AM, Soto A, Gross-Kanner H. Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy. Neurology. 2004;62(5):708–13.
Kraepelin E, Diefendorf AR. Clinical psychiatry (1907). Delmar: Scholars’ Facsimiles and Reprints; 1981. xvii,562p p.
Bleuler E. Textbook of psychiatry. New York: The Macmillan Co; 1924.
Blumer D. Dysphoric disorders and paroxysmal affects: recognition and treatment of epilepsy-related psychiatric disorders. Harv Rev Psychiatry. 2000;8(1):8–17.
Mula M. The interictal dysphoric disorder of epilepsy: a still open debate. Curr Neurol Neurosci Rep. 2013;13(6):355.
Krauthammer C, Klerman GL. Secondary mania: manic syndromes associated with antecedent physical illness or drugs. Arch Gen Psychiatry. 1978;35(11):1333–9.
Mula M, Monaco F. Antiepileptic drug-induced mania in patients with epilepsy: what do we know? Epilepsy Behav. 2006;9(2):265–7.
Klein JP, Jean-Baptiste M, Thompson JL, Bowers Jr MB. A case report of hypomania following vagus nerve stimulation for refractory epilepsy. J Clin Psychiatry. 2003;64(4):485.
Mula M, Monaco F. Antiepileptic drugs and psychopathology of epilepsy: an update. Epileptic Disord. 2009;11(1):1–9.
Bruton CJ, Stevens JR, Frith CD. Epilepsy, psychosis, and schizophrenia: clinical and neuropathologic correlations. Neurology. 1994;44(1):34–42.
Taylor DC. Ontogenesis of chronic epileptic psychoses: a reanalysis. Psychol Med. 1971;1(3):247–53.
Koch-Stoecker S, Schmitz B, Kanner AM. Treatment of postsurgical psychiatric complications. Epilepsia. 2013;54 Suppl 1:46–52.
Carran MA, Kohler CG, O'Connor MJ, Bilker WB, Sperling MR. Mania following temporal lobectomy. Neurology. 2003;61(6):770–4.
Grunze H, Kasper S, Goodwin G, Bowden C, Baldwin D, Licht R, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorders. Part I: treatment of bipolar depression. World J Biol Psychiatry. 2002;3(3):115–24.
Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression. World J Biol Psychiatry. 2010;11(2):81–109.
Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2009 on the treatment of acute mania. World J Biol Psychiatry. 2009;10(2):85–116.
Vieweg V, Shutty M, Hundley P, Leadbetter R. Combined treatment with lithium and carbamazepine. Am J Psychiatry. 1991;148(3):398–9.
Kramlinger KG, Post RM. Addition of lithium carbonate to carbamazepine: hematological and thyroid effects. Am J Psychiatry. 1990;147(5):615–20.
Chen C, Veronese L, Yin Y. The effects of lamotrigine on the pharmacokinetics of lithium. Br J Clin Pharmacol. 2000;50(3):193–5.
Abraham G, Owen J. Topiramate can cause lithium toxicity. J Clin Psychopharmacol. 2004;24(5):565–7.
Erwin CW, Gerber CJ, Morrison SD, James JF. Lithium carbonate and convulsive disorders. Arch Gen Psychiatry. 1973;28(5):646–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Mula, M. (2016). Mania and Elation. In: Mula, M. (eds) Neuropsychiatric Symptoms of Epilepsy. Neuropsychiatric Symptoms of Neurological Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-22159-5_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-22159-5_3
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-22158-8
Online ISBN: 978-3-319-22159-5
eBook Packages: MedicineMedicine (R0)