Organic Causes of Mania

Larson, Eric W.; Richelson, Elliott

doi:10.1016/s0025-6196(12)62694-9

Cited by 62 publications

(13 citation statements)

References 57 publications

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“…Mania is associated with both increased activity (here measured as distance traveled) and risk‐taking behaviors (here measured as time spent in open, lighted areas of an elevated maze). Moreover, mania occurs as a result of temporal lobe seizures as well as during viral encephalitis …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, mania occurs as a result of temporal lobe seizures as well as during viral encephalitis. 23 Neuroinflammation has emerged as a contributor to both ictogenesis and epileptogenesis. 24 Specifically, Toll-like receptor agonists (ie, high mobility group box 1), danger associated molecular pattern receptor agonists (ie, P2X7), inflammatory cytokines (ie, IL-1β, TNF, IL-6, and TGFβ1), chemokines (ie, CCL2, CCL5, CCL3), cyclooxygenase-2, and prostaglandins have recently received attention for their ability to modulate seizure onset and progression in humans and in preclinical models.…”

Section: Discussionmentioning

confidence: 99%

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Indoleamine 2,3‐dioxygenase 1 deletion promotes Theiler's virus–induced seizures in C57BL/6J mice

et al. 2019

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Summary Objective Viral encephalitis increases the risk for developing seizures and epilepsy. Indoleamine 2,3‐dioxygenase 1 (Ido1) is induced by inflammatory cytokines and functions to metabolize tryptophan to kynurenine. Kynurenine can be further metabolized to produce kynurenic acid and the N‐methyl‐d‐aspartate receptor agonist quinolinic acid (QuinA). In the present study, we sought to determine the role of Ido1 in promoting seizures in an animal model of viral encephalitis. Methods C57BL/6J and Ido1 knockout mice (Ido1‐KO) were infected with Theiler's murine encephalomyelitis virus (TMEV). Quantitative real‐time polymerase chain reaction was used to evaluate hippocampal expression of proinflammatory cytokines, Ido1, and viral RNA. Body weights and seizure scores were recorded daily. Elevated zero maze was used to assess differences in behavior, and hippocampal pathology was determined by immunohistochemistry. Results Infected C57BL/6J mice up‐regulated proinflammatory cytokines, Ido1, and genes encoding the enzymatic cascade responsible for QuinA production in the kynurenine pathway prior to the onset of seizures. Seizure incidence was elevated in Ido1‐KO compared to C57BL/6J mice. Infection increased locomotor activity in Ido1‐KO compared to C57BL/6J mice. Furthermore, the occurrence of seizures was associated with hyperexcitability. Neither expression of proinflammatory cytokines nor viral RNA was altered as a result of genotype. Immunohistochemical analysis revealed increased hippocampal pathology in Ido1‐KO mice. Significance Our findings suggest that Ido1 deletion promotes seizures and neuropathogenesis during acute TMEV encephalitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Indoleamine 2,3‐dioxygenase 1 deletion promotes Theiler's virus–induced seizures in C57BL/6J mice

et al. 2019

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“…When first assessing a patient with behavioral symptoms, a thorough neurologic examination and mental status assessment must be made, as certain features can suggest a medical etiology: features regarding orientation, memory or level of consciousness are uncommon in psychiatric disorders, 32 as well as abnormal vital signs or other findings on physical examination. [32][33][34][35][36] Various authors 10,23 have suggested that the differential diagnosis of catatonia due to a medical condition should be divided into simple categories as neurologic, substance-induced, metabolic, infective, and endocrine disorders. Subcategories as encephalitis, seizure disorders, and others should be made, as they allow for a more focused study and practical clinical application.…”

Section: Catatonia Investigationmentioning

confidence: 99%

Catatonia secondary to anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis: a review

Macedo

Marques

2019

CNS Spectr.

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Anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis is a relatively recent autoimmune entity, as it was first described in 2007. Given that it is a condition with neuropsychiatric symptoms, its initial symptom is frequently psychiatric in nature. Hence, psychiatrists are often the first physicians to assess these patients and, as so, must recognize this type of encephalitis as a possible cause. Catatonia may be inaugural or develop throughout the course of the disease. Management of patients with anti-NMDAr encephalitis is based on etiologic treatment with immunotherapy and removal of the associated tumor, if any. However, these catatonic patients may have variable responses to etiologic treatment, sometimes with refractory catatonic symptoms, which attests to the necessary urgency to know how to manage these patients. In the clinical setting, physicians appear to be using guidelines originally created to the management of catatonia due to primary psychiatric conditions. In this literature review, catatonia was historically contextualized and anti-NMDAr encephalitis overall described. Finally, catatonia secondary to this type of encephalitis was discussed.

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“…Mania may be so similar to delirium that it has been termed"acute delirious mania" (Bond, 1980). Again, the EEG may be helpful in detecting secondary manias, i.e., those due to organic impairment (Krauthammer & Klerman, 1978;Larson & Richelson, 1988).…”

Section: Delirium and Dementiamentioning

confidence: 99%

Utility of EEG in Delirium: Past Views and Current Practice

Brenner

1991

Int. Psychogeriatr.

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The EEG is a useful and, at times, an essential test in the evaluation of delirium. In most patients with delirium, the EEG will show diffuse slowing and thus is helpful in differentiating organic etiologies from functional, psychiatric disorders. The degree of the EEG changes correlates with the severity of the encephalopathy so that the EEG may be used to help monitor therapy. In some delirious patients, the EEG may indicate whether the patient is suffering from focal, rather than global, impairment. Furthermore, the EEG is the only test that can identify an ongoing epileptic state (e.g., nonconvulsive status epilepticus) as being responsible for the clinical picture of confusion. Other electrophysiological tests that may prove helpful in the evaluation of delirium, such as computerized EEG spectral analysis, topographic brain mapping, and sleep studies, are briefly reviewed.

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Organic Causes of Mania

Cited by 62 publications

References 57 publications

Indoleamine 2,3‐dioxygenase 1 deletion promotes Theiler's virus–induced seizures in C57BL/6J mice

Indoleamine 2,3‐dioxygenase 1 deletion promotes Theiler's virus–induced seizures in C57BL/6J mice

Catatonia secondary to anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis: a review

Utility of EEG in Delirium: Past Views and Current Practice

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