title: A manic episode with psychotic features improved by methylprednisolone in a patient with multiple sclerosis.
abstract: Several studies have reported a higher prevalence of unipolar depression and bipolar disorder among patients with multiple sclerosis (MS). However, only a few studies have reported manic episodes concomitant with new lesions enhanced by gadolinium on brain magnetic resonance imaging (MRI). Here we report the case of a 47-year-old woman suffering from MS admitted for a manic episode with psychotic features. Brain MRI revealed three new T2 lesions enhanced by gadolinium located in the corpus callosum and in ventromedial prefrontal regions. She rapidly recovered with intravenous methylprednisolone in combination with risperidone. In conclusion, in this patient, the fact that gadolinium-enhancing lesion coincided with new symptoms which responded quickly to corticosteroids suggests that the manic episode was an acute manifestation of MS.
authors: Department of Psychiatry, Rouen University, France. Electronic address: sevan.hotier@gmail.com.
authors: Sevan
authors: S
authors: Hotier
authors: Departement of Neurology, Rouen University, France.
authors: David
authors: D
authors: Maltete
authors: Departement of Neurology, Rouen University, France.
authors: Bertrand
authors: B
authors: Bourre
authors: Department of Psychiatry, Rouen University, France.
authors: Xavier
authors: X
authors: Jegouzo
authors: Department of Psychiatry, Rouen University, France.
authors: Valérie
authors: V
authors: Bourgeois
authors: Department of Psychiatry, Rouen University, France.
authors: Olivier
authors: O
authors: Guillin
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Corticosteroids; Manic state; Multiple Sclerosis; Orbitofrontal; Psychosis