J Neuropsychiatry Clin Neurosci 1989; 1:408-412
Copyright © 1989 by American Neuropsychiatric Association
Emotional behavior after a Wada test in a patient with secondary mania
SE Starkstein, ML Berthier, PL Lylyk, A Casasco, RG Robinson and R Leiguarda
Institute of Neurological Research, Dr. Raul Carrea, Buenos Aires, Argentina.
Soon after treatment of a right basotemporal vascular malformation using an
embolization procedure, a 25-year-old patient developed an acute episode of
mania. Two months later the patient was still manic, and a second
embolization was scheduled. Before it was conducted, a Wada test was
carried out to determine speech dominance. No changes in manic symptoms
were observed after amytal injections into the left middle cerebral, right
frontopolar, or right middle cerebral arteries. This finding suggests that
secondary mania may not be the result of "release" of the left hemisphere
following a right hemisphere lesion but instead may be related to specific
disturbances within the right hemisphere.
