title: Mood disorder as the presenting manifestation of demyelination.
abstract: OBJECTIVE
  To report an unusual presenting manifestation of multiple sclerosis in a teenager.
  
  
  METHODS
  We report the case of a 16-year-old male who was diagnosed with schizoaffective disorder a year prior to his neurological consultation. Neurological examination showed evidence of mild lower extremity spasticity with ataxia and dysarthria. Imaging revealed lesions suggestive of multiple sclerosis.
  
  
  CONCLUSIONS
  An organic basis for psychiatric disorders is often overlooked. Children presenting with symptoms suggestive of a mood disorder, decline in cognition or psychosis deserve a detailed neurological examination and appropriate imaging if indicated, before starting them on antidepressant or neuroleptic medication.
authors.affiliation: Department of Neurology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Mich., USA.
authors.forename: D
authors.initials: D
authors.lastname: Tapos
authors.forename: L
authors.initials: L
authors.lastname: Sivaswamy
keywords: Adolescence; Mood disorder; Multiple sclerosis