Comorbidity of attention-deficit/hyperactivity disorder, Tourette's syndrome and bipolar I disorder in an adolescent patient with schizencephaly.

There is compelling evidence for an association between structural brain deformities and psychiatric disorders. We report the case of an adolescent boy who was diagnosed with both attention-deficit/hyperactivity disorder and Tourette's syndrome. A full-blown manic episode occurred when he was 13 years old. During his admission to a psychiatric ward, closed-lip schizencephaly in the left frontal lobe and the right parietal lobe was identified through brain imaging. Effective control of his manic symptoms was achieved with quetiapine monotherapy within 3 weeks. This case report implies that the pathophysiology of psychiatric disorders, especially in young patients with multiple comorbid conditions, may be associated with abnormalities in the anatomical and functional development of the brain.