Manic phenomena in an adult with Prader-Willi syndrome.

references 1. Butler MG. Prader-Willi syndrome: obesity due to genomic imprinting. Curr Genomics 2011; 12: 204-15. a 37 year old man presented with genetically confirmed Prader-Willi syndrome, a genetic multisystem disorder caused, in this case, by a deletion of the paternal genes in the 15q11-q13 region. The most striking characteristic symptom is relentless pursuit of food with devastating effects on body weight, health and quality of life. The patient lives in a residential home for adults with PraderWilli syndrome where diet is strictly controlled. In the last few years his primary problem was severe behavioral disruption which was treated with a combination of psychiatric medications (risperidone, sertraline, topiramate and clotiapine). During a recent trial to taper down the psychiatric medications, he developed an acute maniphorm psychotic state during which he ate uncontrollably and developed abdominal pain. X-ray demonstrated the presence of metallic objects such as batter2. Cassidy SB, Schwartz S, Miller JL, Driscoll DJ. Prader-Willi syndrome. Genet Med 2012; 14 (1): 10-26.