[High lithium serum level as maintenance treatment of rapid cycling bipolar disorder]. / Hoge lithiumspiegel als onderhoudsbehan­deling van rapid cycling bipolaire stoornis.

Bipolar disorder with a rapid cycling course can be difficult to treat, often involving therapy resistance. A 55-year old patient with bipolar disorder with rapid cycling course did not stabilize for years, despite various pharmacotherapeutic treatments. Only after lithium was introduced as a maintenance treatment at a level of around 1.20 mmol/l, a long-term stabilization of mood developed which also persisted. A literature review was performed which concluded that maintenance treatment with lithium at levels above 1.0 mmol/l in patients with rapid cycling bipolar disorder has not been adequately studied.

[A man with 2 painful feet]. / Een man die niet kan lopen na een sprong.

A 25-year-old man landed a jump with both feet against a vertical rock. He experienced a sharp pain in both ankles and was unable to walk without support. Active plantar flexion could not be performed and the Thompson test was abnormal. The diagnosis bilateral Achilles tendon rupture was made.