The aim of this report was to describe a case of hypomania after deep brain stimulation of the subthalamic nucleus (STN DBS) in a Parkinson’s disease (PD) patient. 59-year-old man with a 15-year history of PD underwent bilateral implantation of electrodes to the STN. Immediately after surgery, his motor function was markedly improved and his mood was elevated to hypomania. Fusion images of the preoperative MRI and postoperative CT scan showed that the electrodes were located in the medial portion of the STN. In this case, behavioral mood change was related to the deep brain stimulation. Moreover, the anatomical location and the functional alteration of the STN after the DBS surgery might be related to the regulatory system of the associative and limbic cortico-subcortical circuits.

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Mood disorders following acute stroke are relatively common. However, restlessness with manic episodes has rarely been reported. Lesions responsible for post-stroke mania can be located in the thalamus, caudate nucleus, and temporal and frontal lobes. We present a patient who exhibited restlessness with manic episodes after an acute infarction in the right parietal lobe, and summarize the case reports involving post-stroke mania. The right parietal stroke causing mania in our case is a novel observation that may help us to understand the mechanisms underlying restlessness with mania following acute stroke.

Citations

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• Restlessness with manic episodes induced by right-sided multiple strokes after COVID-19 infection: A case report
  Takahiko Nagamine
  Brain Circulation.2023; 9(2): 112.     CrossRef
• Poststroke Mania During the COVID-19 Pandemic
  Takahiko Nagamine
  Journal of Nervous & Mental Disease.2023; 211(12): 979.     CrossRef
• Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury
  Gautam Saha, Kaustav Chakraborty, Amrit Pattojoshi
  Indian Journal of Psychiatry.2022; 64(Suppl 2): S344.     CrossRef
• Post stroke delirium
  M. A. Savina
  Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova.2014; 114(12. Vyp. 2): 19.     CrossRef