Bipolar disorder is a chronic mood disorder with the peak age of onset between 20 and 40 years. The majority of patients have onset prior to age 50. Age of onset can have a significant impact on the etiology, nature and course of the illness. Mania in old age needs a careful assessment for underlying neurological diseases, especially cerebrovascular disease. A 84 year old woman who had complaints of excessive and meaningless talking, irritability, restlessness, anger and insomnia for the first time in her life is presented in this case report. The patient was evaluated and diagnosed as first episode manic attack. Rarity of first manic attack in old age is the significant aspect of the case. Taking notice of items about diagnosing and treating in this kind of patients are discussed in this case report.
Key words: Bipolar disorder, mania, late onset
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