John's behavioural and affective changes, first diagnosed as a primary mood disorder, were then attributed to a head injury, supported by an abnormal CT. The case highlights two important principles: first, the importance of a detailed history, which revealed that the behavioural and cognitive changes had occurred years after the head injury, and second, the utility of MRI compared with non-contrast CT. FundingThis research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

No abstract

AimsTheory of mind (ToM) is the ability to represent one's own and other's mental state. Studies in bipolar affective disorder show mixed results possible due to confounding factors like intelligence, attention, phase of illness and current mood. Purpose of this study is to study ToM in remittent bipolar disorder patients and compare with normal controls to find if there are residual deficits during remissionMethods40 bipolar patients in remission and 40 age and sex matched controls were recruited. Clinical remission for 3 months with YMRS <4 and HAM-D <7 was inclusion criteria. ToM was assessed by Faux Pas test. Data were analysed using SPSS-11.5 for Windows with parametric and non-parametric tests as indicated. Level of significance taken as p < 0.05 (two tailed).ResultsMean age of onset of illness in patient group was 23.8 years with duration of illness 11.3 years. Mean number of episodes 6.7 and duration of remission 4.15 months. ToM test result revealed deficit in recognizing social cues in faux pas test by bipolar patients as compared to normal controls. There was no difference between both groups in test result on control stories.ConclusionResults suggest that ToM deficits are present in bipolar disorder patients even during apparent clinical remission, indicating it may be a trait marker of the illness. There is no deficit in understanding a regular social context without faux pas. It also revealed that there is no correlation with ToM and duration of illness

Meige syndrome is an idiopathic dystonia characterized by combination of blepharospasm and involuntary movements of the lower facial and/or masticatory (jaw) muscles. The condition is rare and has a variety of clinical presentations which often lead to its misdiagnosis. We report a case of Meige syndrome repeatedly misdiagnosed and treated unsuccessfully as conversion disorder.