Secondary Mania

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To the Editor. — The review on secondary mania (SM) by Krauthammer and Klerman (Archives 1978;35:1333-1339) fails to find any reported cases of neurosyphilis (NS), which manifests itself as mania without confusion (ie, as SM). Recently, Binder and Dickman1 provided an example of mania secondary to NS, and here we offer yet another case report of NS imitating the features of a clear-cut mania. Report of a Case. — A 34-year-old man was admitted to our hospital with a sixmonth history of right-sided jacksonian attacks and transient aphasie episodes and with a seven-day history of global aphasia. He had never been neurologically or psychiatrically ill, he had no history of syphilis, and there was no evidence of affective illness in his family. The results of physical, neurological, and psychiatric examinations on admission were unremarkable, except for a global aphasie picture. The results of laboratory investigations, including x-ray films of the chest and skull, ECG, EEG, and left carotid arteriogram, were all essentially within normal limits, except

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