The Clinical Spectrum of Bipolar Symptoms in Epilepsy: A Critical Reappraisal

Mula, Marco

doi:10.3810/pgm.2010.07.2171

Cited by 15 publications

(17 citation statements)

References 74 publications

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“…Studies of primary neurons suggested that enhanced calcium-dependent signal-transduction pathways downstream of NKA may underlie the behavioural phenotypes and are potential therapeutic targets (88). Myk mice therefore provide important insights into neuronal signalling in mania, particularly as epilepsy and bipolar disorder can be co-morbid in humans (89). …”

Section: Neuropsychiatric Diseasementioning

confidence: 99%

New insights into behaviour using mouse ENU mutagenesis

Oliver

Davies

2012

Human Molecular Genetics

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Identifying genes involved in behavioural disorders in man is a challenge as the cause is often multigenic and the phenotype is modulated by environmental cues. Mouse mutants are a valuable tool for identifying novel pathways underlying specific neurological phenotypes and exploring the influence both genetic and non-genetic factors. Many human variants causing behavioural disorders are not gene deletions but changes in levels of expression or activity of a gene product; consequently, large-scale mouse ENU mutagenesis has the advantage over the study of null mutants in that it generates a range of point mutations that frequently mirror the subtlety and heterogeneity of human genetic lesions. ENU mutants have provided novel and clinically relevant functional information on genes that influence many aspects of mammalian behaviour, from neuropsychiatric endophenotypes to circadian rhythms. This review will highlight some of the most important findings that have been made using this method in several key areas of neurological disease research.

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Section: Neuropsychiatric Diseasementioning

confidence: 99%

New insights into behaviour using mouse ENU mutagenesis

Oliver

Davies

2012

Human Molecular Genetics

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“…In fact, IDD seems to be closer to bipolar depression rather than to unipolar one [20,28,29] and psychoses of epilepsy are characterized by a preserved personality and prominent mood symptoms [30] suggesting that psychoses of epilepsy belong to the mood spectrum rather than to the psychotic spectrum. However, the symptom cluster described in patients with IDD and epilepsy is quite peculiar and is rarely reported in psychiatric practice even in rapid cycling bipolar disorders or cyclothymia [28]. Probably for this reason, Blumer stated that IDD is unique for epilepsy [27].…”

Section: The Non-conforming Features Of Mood Disorders In Epilepsy Anmentioning

confidence: 99%

The interictal dysphoric disorder of epilepsy: Legend or reality?

Mula

2016

Epilepsy & Behavior

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For a long time, the relationships between epilepsy and mood disorders captured the attention of clinicians and neuroscientists. The existence of a peculiar clinical presentation for mood disorders in epilepsy has been matter of debate since the early reports of Kraepelin and Bleuler. The interictal dysphoric disorder (IDD) represents the modern reinterpretation of such early observations. This paper reviews current research on this topic discussing clinical implications, phenomenological observations and directions for future research.

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“…Epilepsy is associated with affective syndromes which could be classified according to their relation to the ictus of seizures [9,10]. One of these syndromes, the interictal dysphoric disorder, has a course of illness mimicking an 'unstable bipolar II disorder' [11].…”

Section: Abstract: Bipolar Disorder Epileptiform Discharges Sharp Amentioning

confidence: 99%

Differences in course of illness between patients with bipolar II disorder with and without epileptiform discharges or other sharp activity on electroencephalograms: a cross-sectional study

et al. 2020

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Background A diagnosis of bipolar II disorder requires that the symptoms cannot be better explained by a medical condition. Epilepsy is in some cases associated with an affective syndrome mimicking an unstable bipolar II disorder. Epileptiform discharges on electroencephalograms (EEGs) are typical, but not pathognomonic, for epilepsy. A previous study has found a high frequency of epileptiform discharges and other sharp activity among patients with bipolar disorder. The aim of the study was to identify if epileptic discharges or other sharp activity per se are associated with an altered course of illness among patients with bipolar II disorder. Methods Eighty six patients diagnosed with bipolar II disorder at two psychiatric departments were interviewed about prior course of illness and assessed with EEGs. The patients were split into two groups based on the presence (n = 12) or absence (n = 74) of epileptiform discharges or other sharp activity. Wilcoxon rank sum test, Fisher’s exact test, and Pearson’s chi squared test were used to assess differences between the groups on six variables of course of illness. Results Patients with epileptiform discharges or other sharp activity had a history of more hypomanic episodes per year (median (interquartile range (IQR)) 1.5 (3.2) vs. 0.61 (1.1), p = 0.0090) and a higher hypomania:depression ratio (median (IQR) 3.2 (16) vs. 1.0 (1.0), p = 0.00091) as compared to patients without. None of the patients with epileptiform discharges or other sharp activity had self-reported epileptic seizures in their history. Conclusions Epileptiform discharges or other sharp activity on EEGs are associated with more hypomanic episodes and an increased hypomania:depression ratio. Our results warrant replication in prospective studies, but suggest that EEG findings could be of prognostic importance for patients diagnosed with bipolar II disorder in psychiatric care. Trial registration ClinicalTrials.gov (NCT00201526).

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The Clinical Spectrum of Bipolar Symptoms in Epilepsy: A Critical Reappraisal

Cited by 15 publications

References 74 publications

New insights into behaviour using mouse ENU mutagenesis

New insights into behaviour using mouse ENU mutagenesis

The interictal dysphoric disorder of epilepsy: Legend or reality?

Differences in course of illness between patients with bipolar II disorder with and without epileptiform discharges or other sharp activity on electroencephalograms: a cross-sectional study

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