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Is it reasonable to assume that just about everyone becomes depressedfollowing a stroke? Which neuropsychiatric manifestations are most readily confused with the signs and symptoms of depression? How canone determine whether unusual convulsive symptoms are manifestationsof true seizure activity or psychogenic episodes?Neuropsychiatric sequelae of cerebrovascular accidents (CVAs) arecommon and varied. The presented case highlights aspects of the neuropsychiatric evaluation of a poststroke patient with mood symptoms andunusual seizure-like activity.