"Extremely Bright" & Bipolar Disorder
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Q:  "Extremely Bright" & Bipolar Disorder

My 10 year old has a history of epilepsy.  Three years ago she had significant neurocognitive decline after a normal bacterial infection.  She finally returned to normal and then relasped after a viral infection.  PET scans showed that broad sections of the cingulate gyrus and the right frontal lobe had slowed significantly. (Spiking also occurs in right frontal lobe.) She now has an IVIG every 28 days, and we had seen remarkable results.

My 15 year old has just been diagnosed with bipolar disorder.  Both girls are extremely bright with test scores above the 99th%.  Are the two conditions possibly related, or is it just a strange coincidence that I have two children with brains that don't function normally?     

Dear Ms. H' -- 
You're certainly right to wonder.  You've probably learned that bipolar disorder and epilepsy seem to have a great deal in common:  anticonvulsants work in each; sleep deprivation makes both worse; alcohol makes both worse; both have genetically transmissible susceptibility; head injuries are associated with both, etc. 

"Extremely bright" is also associated with bipolar disorder, at least in a broad range of anecdotal literature:   many websites list "famous people" (e.g. enter bipolar famous people on Google), really unusually creative people like Beethoven and Abe Lincoln, who are thought to have had bipolar disorder -- with varying degrees of effort having been expended to be very certain about this) and certainly in my experience with patients as well. 

You know the imprecation "may you live in interesting times" (which -- I just had to look it up re: origin -- has a very odd history).  I can imagine that at times you've felt you were on the receiving end of something like "may you have very intelligent children".  Thank you for contributing their story to my databanks; the relationship between infection and cognitive function in your younger is very odd, isn't it.  Good luck with handling these complex situations.  

Dr. Phelps


Published January, 2005


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