Very-late Onset Mania Episode: Case Report and Review of Cases Over 75 Years of Age
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Date
2019-08
Journal Title
Journal ISSN
Volume Title
Publisher
International Society for Contemporary Medical Research
Abstract
Introduction: Bipolar I disorder typically characterized bycycles of depression and mania. Onset after the age of 75 yearsis very rare and the reported incidence of mania is 2/100000,which most often occur due to secondary organic aetiology.Here we are presenting a review and an interesting case oflate-onset first episode mania while evaluating and excludingall other secondary causes of mania.Case Report: 79-year-old male presented with 2 weeks’duration of illness and symptoms was suggestive of a manicepisode. The patient was thoroughly assessed with laboratoryinvestigations and non-contrast computerised tomography(NCCT) brain to find any secondary causes of mania butnothing was significant. Finally, as per tenth revision of theInternational Statistical Classification of Diseases (ICD-10)diagnosis of first episode Mania without psychotic symptoms(F30.1) was made. He was started on Valproate which wasgradually increased up to 750 mg/day and olanzapine 5mg.After 6 weeks, the YMRS score decreased from 32 to 8 and heachieved his premorbid functioning level.Conclusion: This case highlights that primary psychiatryillness can occur at any age but in the geriatric populationbefore finalizing the diagnosis all other secondary causesshould be ruled out. There is a high need for systematicresearch in this area to formulate effective managementguidelines in the geriatric population.
Description
Keywords
Bipolar Disorder; Late Age Of Onset; First Episode Mania; Secondary Mania
Citation
Singh Jawahar, Verma Rohit, Kumar Vijay, Kaur Ramandeep. Very-late Onset Mania Episode: Case Report and Review of Cases Over 75 Years of Age. International Journal of Contemporary Medical Research . 2019 Aug; 6(8): h22-h24