{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T12:22:19Z","timestamp":1761740539958},"reference-count":33,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Psychiatry"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Age of onset can have a significant impact on clinical course and pathophysiological mechanism of bipolar disorder. Late-onset bipolar episodes are more likely linked to medical illnesses and so are frequently classified as \u201csecondary\u201d forms of mood disorder. We discuss the case of a patient who at the age of 58 presented his first delusional-manic episode. He also had mild frontal and occipital cortical atrophy, white matter posterior ischemic lesions, and small basal ganglia calcifications. Seven years later, he presented a second manic episode with new emergent hyperkinetic choreiform symptoms. Taking into account movement disturbances, the presence of basal ganglia calcification, and worsening of cortical atrophy, we performed a differential diagnosis between Fahr disease, Fahr\u2019s syndrome, calcifications due to ageing, supersensitivity psychosis, and dementia. Valproate, quetiapine, and tetrabenazine were sequentially administered and yielded a good therapeutic response as regards manic and movement symptoms. Relationship between medications and course of specific symptoms was observed.<\/jats:p>","DOI":"10.1155\/2016\/1393982","type":"journal-article","created":{"date-parts":[[2016,4,24]],"date-time":"2016-04-24T21:00:35Z","timestamp":1461531635000},"page":"1-5","source":"Crossref","is-referenced-by-count":3,"title":["Late-Onset Mania in a Patient with Movement Disorder and Basal Ganglia Calcifications: A Challenge for Diagnosis and Treatment"],"prefix":"10.1155","volume":"2016","author":[{"given":"Beatrice","family":"Roiter","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Section of Psychiatry, University of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Pigato","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Section of Psychiatry, University of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Perugi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pisa, 56121 Pisa, Italy"},{"name":"The Institute of Behavioral Sciences \u201cG. 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