The authors present psychiatric and neurologic data on 20 patients who
developed mania after closed head trauma. An association was seen between
severity of head trauma (based on length of posttraumatic amnesia),
posttraumatic seizure disorder, and type of bipolar disorder. The manic
episodes were characterized by irritable mood rather than euphoria and by
assaultiveness. Psychosis occurred in only 15% of the sample, and 70% had
no depressive episodes. Bipolar disorders were absent among 85 first-degree
relatives. The authors suggest that posttraumatic seizures may be a
predisposing factor in posttraumatic mania.
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