Bipolar disorder in idiopathic dystonia: clinical features and possible neurobiology

• Published in: The journal of neuropsychiatry and clinical neurosciences Vol. 4; no. 4; pp. 435 - 439
• Main Authors: Lauterbach, E C, Spears, T E, Price, S T
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Publishing 1992
• Subjects: Antidepressive Agents - therapeutic use; Bipolar Disorder - diagnosis; Bipolar Disorder - drug therapy; Bipolar Disorder - psychology; Clonazepam - therapeutic use; Cyclothymic Disorder - diagnosis; Cyclothymic Disorder - drug therapy; Cyclothymic Disorder - psychology; Drug Therapy, Combination; Dystonia - diagnosis; Dystonia - drug therapy; Dystonia - psychology; Female; Humans; Lithium Carbonate - adverse effects; Lithium Carbonate - therapeutic use; Male; Middle Aged; Neurocognitive Disorders - diagnosis; Neurocognitive Disorders - drug therapy; Neurocognitive Disorders - psychology; Psychiatric Status Rating Scales; Trihexyphenidyl - therapeutic use
• ISSN: 0895-0172; 1545-7222
• DOI: 10.1176/jnp.4.4.435

The authors report 5 patients with bipolar disorders in the context of primary idiopathic dystonia. Four patients had DSM-III-R bipolar disorder, mixed, and one had cyclothymic disorder as diagnosed using the Structured Clinical Interview for DSM-III-R (SCID). All cases of bipolar disorder manifested rapid cycling. Three patients with bipolar disorder experienced onset of this illness soon after the onset of cervicocranial dystonia (5 neck dystonia, 4 craniofacial, 2 brachial, 1 vocal cord, 1 thoracic). These cases apparently represent a first report of bipolar disorders in dystonia. Clinical management, relevant literature, and putative neurobiology are reviewed.