Do you have any sort of citation for this? I’m not trying to be snarky, I’d really like to read more.

My understanding of the med lit is that bipolar and epilepsy aren’t particularly associated, and pure BD in particular is a rarity - when epileptic patients were assessed for BD symptoms, they were mostly only found in the confusional states pre- and post-seizure, which isn’t BD at all.

At least in my hospital, the most common way we get BD patients hospitalized is either during a severe depressive episode, or when their mania results in violence or law-breaking. We do sometimes have patients land on our floor whose first presentation was seizure, but that’s after they’re assessed by neuro and found that it was pseudoseizure (factitious seizure).