@article{ref1,
title="Late onset bipolar disorder due to a lacunar state",
journal="Behavioural neurology",
year="2014",
author="Antelmi, E. and Fabbri, M. and Cretella, L. and Guarino, M. and Stracciari, A.",
volume="2014",
number="",
pages="-",
abstract="To describe a patient with a new onset bipolar disorder (BD) type II, secondary to a lacunar state.Background. Poststroke BD is rare and mainly associated with lesion in the prefrontal-striatal-thalamic circuit. <br><br>MATERIALS AND METHODS. A 51-year-old woman came to our attention for a mood disorder of recent onset. At 49, she had suffered acute left-sided limb weakness that improved spontaneously four days later. Arterial hypertension was subsequently diagnosed. After 6 months, she began to suffer from alternating brief periods of expansive and elevated mood with longer periods of depressed mood, with a suicide attempt.We performed extensive laboratory and instrumental investigations, as well as, psychiatric consultation, and a cognitive assessment, which was repeated 9 months later. <br><br>RESULTS. Brain magnetic resonance disclosed leukoaraiosis and a lacunar state of the basal ganglia. Transcranial Doppler showed a patent foramen ovale. A psychiatric consultation led to the diagnosis of BP type II. Neuropsychological evaluation detected deficits in attention/executive functions, verbal fluency, and memory. Nine months later, after specific psychiatric therapy, the psychiatric symptoms were remarkably improved. <br><br>CONCLUSION. Our case sheds light on the role of the basal ganglia in mood disorders and the importance of ruling out brain injury in late onset BP. Copyright © 2014 Giovanni A.<p /><p>Language: en</p>",
language="en",
issn="0953-4180",
doi="10.1155/2014/780742",
url="http://dx.doi.org/10.1155/2014/780742"
}