Rapid cycling in severely multidisabled children: a form of bipolar affective disorder?

Abstract:

:A debilitating, regularly recurring, biphasic disorder is described in 6 severely multidisabled children. It was characterized by several days of lethargy, withdrawal, loss of abilities, irritability, and hypersomnolence followed or preceded by a high-energy state for several days during which the children slept very little, at times were euphoric, had improved mental ability, and were hyperactive. These cyclic episodes had been present for years but unexpectedly disappeared in one child. The etiology is unknown, in spite of detailed neurologic, metabolic, and endocrine investigations. All patients had family histories positive for affective disorder. Melatonin treatment helped to regulate the coexisting chronic sleep disorders of 3 children but failed to eliminate the cycles. Antiepileptic drug treatment, lithium, sedatives, stimulants, tranquilizers, and light therapy were largely ineffective. The children's symptoms and signs fit the diagnostic criteria of a bipolar affective illness, as it was modified for patients with associated neurologic disability; therefore, the patients appeared to have a unique disorder that closely resembles or is a variant of rapid cycling affective disorder.

journal_name

Pediatr Neurol

journal_title

Pediatric neurology

authors

Jan JE,Abroms IF,Freeman RD,Brown GM,Espezel H,Connolly MB

doi

10.1016/0887-8994(94)90064-7

subject

Has Abstract

pub_date

1994-02-01 00:00:00

pages

34-9

issue

1

eissn

0887-8994

issn

1873-5150

pii

0887-8994(94)90064-7

journal_volume

10

pub_type

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