MANIA IN PARKINSON'S DISEASE WITH TREATMENT EMERGENT DYSKINEISA : A CASE REPORT

A case of parkinson's disease starting 7 yrs. ago in 1993 with 2 episodes of mania is presented. The 1st episode (1993) was of 1-1/2 months duration, when early parkinsons symptoms had already set in. This was treated with anti-psychotic medications for a month, the picture was complicated with stroke and post-stroke sequlae for 5-6 months, where anti-psychotics were continued. He developed dyskinesia, when antipsychotics were stopped. The patient was on selegiline for Parkinson's disease for 2 years and off all medications subsequently. The 2nd episode of mania occurred after 7 years in January 2000. This episode of mania lasting for 2 months duration was treated with divalproate sodium and I-dopa for Parkinson's. Treatment emergent dyskinesia had to be treated with Clozapine. This unusual combination of bipolar-l disorer (2 episodes of mania) with Parkinson's disease and treatment emergent dyskinesia is presented with management strategy.