Bipolar Disorder and Multiple Sclerosis: A Case Series

Background. The prevalence of psychiatric disturbance for patients with multiple sclerosis (MS) is higher than that observed in other chronic health conditions. We report three cases of MS and bipolar disorder and we discuss the possible etiological hypothesis and treatment options. Observations. Al...

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Main Authors: Youssef Sidhom, Mouna Ben Djebara, Yosr Hizem, Istabrak Abdelkefi, Imen Kacem, Amina Gargouri, Riadh Gouider
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:Behavioural Neurology
Online Access:http://dx.doi.org/10.1155/2014/536503
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spelling doaj-189c66cd99714f97bf3c709fcf16319b2021-07-02T18:13:35ZengHindawi LimitedBehavioural Neurology0953-41801875-85842014-01-01201410.1155/2014/536503536503Bipolar Disorder and Multiple Sclerosis: A Case SeriesYoussef Sidhom0Mouna Ben Djebara1Yosr Hizem2Istabrak Abdelkefi3Imen Kacem4Amina Gargouri5Riadh Gouider6Department of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaDepartment of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaDepartment of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaDepartment of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaDepartment of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaDepartment of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaDepartment of Neurology, Razi Hospital, Manouba, 2010 Tunis, TunisiaBackground. The prevalence of psychiatric disturbance for patients with multiple sclerosis (MS) is higher than that observed in other chronic health conditions. We report three cases of MS and bipolar disorder and we discuss the possible etiological hypothesis and treatment options. Observations. All patients fulfilled the McDonald criteria for MS. Two patients were followed up in psychiatry for manic or depressive symptoms before developing MS. A third patient was diagnosed with MS and developed deferred psychotic symptoms. Some clinical and radiological features are highlighted in our patients: one manic episode induced by high dose corticosteroids and one case of a new orbitofrontal MRI lesion concomitant with the emergence of psychiatric symptoms. All patients needed antipsychotic treatment with almost good tolerance for high dose corticosteroids and interferon beta treatment. Conclusions. MRI lesions suggest the possible implication of local MS-related brain damage in development of pure “psychiatric fits” in MS. Genetic susceptibility is another hypothesis for this association. We have noticed that interferon beta treatments were well tolerated while high dose corticosteroids may induce manic fits.http://dx.doi.org/10.1155/2014/536503
collection DOAJ
language English
format Article
sources DOAJ
author Youssef Sidhom
Mouna Ben Djebara
Yosr Hizem
Istabrak Abdelkefi
Imen Kacem
Amina Gargouri
Riadh Gouider
spellingShingle Youssef Sidhom
Mouna Ben Djebara
Yosr Hizem
Istabrak Abdelkefi
Imen Kacem
Amina Gargouri
Riadh Gouider
Bipolar Disorder and Multiple Sclerosis: A Case Series
Behavioural Neurology
author_facet Youssef Sidhom
Mouna Ben Djebara
Yosr Hizem
Istabrak Abdelkefi
Imen Kacem
Amina Gargouri
Riadh Gouider
author_sort Youssef Sidhom
title Bipolar Disorder and Multiple Sclerosis: A Case Series
title_short Bipolar Disorder and Multiple Sclerosis: A Case Series
title_full Bipolar Disorder and Multiple Sclerosis: A Case Series
title_fullStr Bipolar Disorder and Multiple Sclerosis: A Case Series
title_full_unstemmed Bipolar Disorder and Multiple Sclerosis: A Case Series
title_sort bipolar disorder and multiple sclerosis: a case series
publisher Hindawi Limited
series Behavioural Neurology
issn 0953-4180
1875-8584
publishDate 2014-01-01
description Background. The prevalence of psychiatric disturbance for patients with multiple sclerosis (MS) is higher than that observed in other chronic health conditions. We report three cases of MS and bipolar disorder and we discuss the possible etiological hypothesis and treatment options. Observations. All patients fulfilled the McDonald criteria for MS. Two patients were followed up in psychiatry for manic or depressive symptoms before developing MS. A third patient was diagnosed with MS and developed deferred psychotic symptoms. Some clinical and radiological features are highlighted in our patients: one manic episode induced by high dose corticosteroids and one case of a new orbitofrontal MRI lesion concomitant with the emergence of psychiatric symptoms. All patients needed antipsychotic treatment with almost good tolerance for high dose corticosteroids and interferon beta treatment. Conclusions. MRI lesions suggest the possible implication of local MS-related brain damage in development of pure “psychiatric fits” in MS. Genetic susceptibility is another hypothesis for this association. We have noticed that interferon beta treatments were well tolerated while high dose corticosteroids may induce manic fits.
url http://dx.doi.org/10.1155/2014/536503
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