Secondary mania may be caused by metabolic derangements, intoxications, and/or structural lesions, as well as by epilepsy. The authors describe a maniclike illness in a 16-year-old girl in whom a right frontal arteriovenous malformation was discovered. The most effective medical therapy was a combination of lithium and carbamazepine. Ultimately, the malformation was resected, and since then the patient has done well without medication. The possibility is raised that mania may be the presenting syndrome of a seizure disorder that is secondary to an organic lesion.
J Clin Psychiatry. 1988 Mar;49(3):119-20.