Korean Journal of Biological Psychiatry

A case of rapid cycling mania secondary to gamma-knife radiosurgery for the treatment of refractory epilepsy was reported. A 21-year old woman who had a gamma-knife radiosurgical operation for the treatment of refractory seizure two years ago was admitted because of manic episodes. Although seizure was relieved, manic symptoms like decreased need for sleep, elated mood, unprovoked laughing, grandiose delusion and bizarre behaviors were developed 11 months after the operation. These symptoms recurred four times for eight months. There were no past personal and family history of mood disorders. Laboratory examinations including electroencephalogram and endocrinological study did not show any abnormal findings. The rapid cylcing secondary mania was relieved by lithium. She was then discharged after 5 months. Mood change was not significant during follow-up while hypomania emerged by dose reduction. The secondary mania seemed to be caused or triggered by the right temporal lobe damage induced by gamma-knife radiosurgery.

Keywords Gamma-knife radiosurgery;Rapid cycling secondary mania;Seizure;Temporal lobe;Lithium.