A 1961 report by Wohlfart described a postman known as K.R. who contracted encephalitis lethargica at the age of 12.[2] While he reported no significant ill effects from the disease, he was irritable and complained of fatigue for years after recovering. At 22, the patient received a head injury, though he did not sustain a concussion or cranial fracture from the incident. Six months later, he developed oculogyric spasms, as well as dyskinesias of the mouth and tongue.[2] At the age of 44, the patient experienced his first bout of klazomania.[2] He remained conscious for the entire incident, while he shouted for about half an hour and appeared "crazy" for hours after the shouting ended.