Table 1: Summary of the time course of events of the six patients with post-stroke mania.

Age and sex	Initial event	Neurological findings	Preceding psychiatric history	Time to onset of mania	Result
1. 79-year-old female	Fall with confusion and gait instability 8 weeks before admission; similar episode 1 week before admission; similar episode day of admission.	On admission, Dysarthria-clumsy hand syndrome x 5 days, plus gait and balance disturbance, and nystagmus	Anxiety and depression	At the time of her second fall, one week before admission	Resolved with 200 mg/day quetiapine; returned on discontinuation; resolved on resumption.
2. 85-year-old female	Fall	Dysarthria-clumsy hand syndrome x 2 days; delirium	3 year history of minor neurocognitive disorder	Hours; 7 days after admission MRI showed new lacunar infarct in the area of the head of the caudate and the putamen	Resolved with 25 mg daily quetiapine; returned on discontinuation; resolved on resumption.
3. 76-year-old female	Fall 2 months previous and again just before admission	Increased lateral nystagmus with disturbance of gait and balance. MRI showed new small lacunar infarct in the area of the left basal ganglia	No previous psychiatric history	Onset after the first fall with excessive spending and generosity and irritability and suspiciousness	Resolved with 50 mg quetiapine bid; returned on discontinuation; resolved on resumption.
4. 8o-year-old female.	Acute onset of delirium.	Left, medial parieto-temporal lobe infarct with previous lacunar infarcts in the basal ganglia	No previous psychiatric history	Mania appeared as the delirium resolved.	Resolution with 50 mg/day quetiapine
5. 81-year-old male	Acute onset of gait and balance disturbance and hypersexuality with pressured speech loss of memory, and irritability	Left, medial temporal lobe infarct with severe periventricular small vessel disease	Anxiety and Depression	Mania diagnosed from irritability, hypersexuality, and pressured speech.	Improvement but not resolution with 225 mg quetiapine/day and 50 mg sertraline/day.
6. 90-year-old female	Fall	Disturbance of gait and balance and sensory loss only right arm and leg x 5 days. MRI old basal ganglia lacunar infarcts	No previous psychiatric history	Acute onset of sleeplessness with irritability and strident demands for unnecessary services and items; pressured and loquacious speech, not always understandable; suspiciousness	Substantial improvement with 0.5 mg risperidone per day.