DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.052

Pages: 2876-2878

Bipolar disorder is frequently associated with medical comorbidities that complicate its clinical course and prognosis. Among these, epilepsy represents a significant risk factor for psychiatric morbidity and may contribute to diagnostic and therapeutic challenges. We report the case of a 49-year-old man with a history of thyroidectomy, type 2 diabetes, and bilateral frontal epilepsy, who presented with an acute manic episode. The episode occurred in the context of poor sleep, irritability, psychosocial stressors, and partially controlled epilepsy. A diagnosis of bipolar I disorder was confirmed, considering a previous psychiatric hospitalization concomitant with the onset of seizures. This case illustrates the complex relationship between bipolar disorder and epilepsy, as well as the impact of metabolic and endocrine comorbidities—such as diabetes and thyroid dysfunction—on seizure frequency, mood instability, and treatment response. Specific diagnostic considerations include differentiating bipolar manifestations from epilepsy-related dysphoric disorders. Therapeutic management must account for interactions between psychotropic and antiepileptic medications, the risk of lowering seizure threshold, and the need for regular neurological and endocrinological monitoring. This observation highlights the importance of early recognition and integrated care for comorbid conditions in bipolar patients, given their significant somatic morbidity and mortality.