27th National Clinical Education Symposium Presentation Abstracts
29 APRIL 2025, MONDAY
13:00-14:00 POSTER PRESENTATION SESSION-2
Elevation of mood observed in a manic patient following subinsular area infarct
Halil İbrahim Yamaç1, Mustafa Onur Zeybek1, Mahmut Selçuk2
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Show more (Affiliations)
1. Muğla Eğitim ve Araştırma Hastanesi
2. Muğla Sıtkı Koçman Üniversitesi
DOI: 10.5080/kes27.abs126 Page 152
OBJECTIVE:Insula in various experimental and clinical studies; has been shown to be linked to mood. This case will present a patient diagnosed with who experienced an infarction in the subinsular region during a manic episode and the elevation observed in her mood following the infarction. CASE (The patient consent must be provided and specified with appropriate terms.):A 56-year-old, single female patient was diagnosed with Bipolar Affective Disorder 22 years ago. She was admitted to our service with a manic episode. During the psychiatric evaluation at admission, her mood was elevated and euphoric. On the 26th day of her hospitalization, her euphoria had diminished, her mood and affect were labile, she had no irritability. On the 27th day of her hospitalization, she presented with complaints and findings of inability to articulate, difficulty in finding words, and facial asymmetry, leading to a diffusion MRI. The diffusion MRI reported a focal active stage ischemic focus extending from the right lateral ventricle body to the subinsular region, with diffusion restriction. The patient was referred to neurology, and treatment with acetylsalicylic acid 100 mg and clopidogrel 75 mg was initiated. Follow-up psychiatric evaluations revealed irritability, psychomotor agitation, and excitation in the patient. On the first day of hospitalization, the young mania score was 27, 18 before the infarction, and 27 after the infarction. A significant regression was observed in manic symptoms after infarction treatment. Written informed consent was obtained. DISCUSSION:It has been documented in the literature that subinsular region infarction is rare and occurs in 0.4% of all ischemic brain infarctions. The elevation in mood observed in this patient following an infarction in the subinsular area demonstrates the importance of the insular cortex in emotional functions.