Elsevier

Psychosomatics

Volume 50, Issue 3, May–June 2009, Pages 285-288
Psychosomatics

Case Report
Recurring Episodes of Bell’s Mania After Cerebrovascular Accident

https://doi.org/10.1176/appi.psy.50.3.285Get rights and content

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 lorazapam 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.

Cited by (0)

View Abstract