Abstract:
BACKGROUND:Bell's mania (mania with delirium) is an acute neurobehavioral syndrome of unknown etiology that is characterized by the rapid onset of grandiosity, psychomotor excitement, emotional lability, psychosis, and sleep disruption consistent with mania, coupled with alterations in sensorium, and disorientation characteristic of delirium. Catatonia is a common feature of the syndrome. METHOD:The authors describe a case of recurrent delirium/mania with prominent catatonic features after a cerebellar and pontine stroke, and subsequent successful treatment with lorazepam. RESULTS:Symptoms quickly resolved after antipsychotics were discontinued, with continuation of valproate and lorazepam treatment. DISCUSSION:Failure to recognize this patient's syndrome as a form of catatonia could have had severe, even life-threatening, consequences. The use of neuroleptic medications in cases of delirium/mania with catatonic signs may result in marked clinical deterioration, whereas high-dose lorazepam can ameliorate catatonic signs.
journal_name
Psychosomaticsjournal_title
Psychosomaticsauthors
Bobo WV,Murphy MJ,Heckers SHdoi
10.1176/appi.psy.50.3.285subject
Has Abstractpub_date
2009-05-01 00:00:00pages
285-8issue
3eissn
0033-3182issn
1545-7206pii
S0033-3182(09)70801-1journal_volume
50pub_type
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