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Mania Associated with Multiple Sclerosis
CITATION:  Miao, YK.  (2003). Mania Associated with Multiple Sclerosis.  Hong Kong J Psychiatry 13(1):34-38.

ABSTRACT:   Mania sometimes occurs in association with an organic condition in the brain. A 29-year-old housewife with secondary mania related to multiple sclerosis is described. The case highlights the importance of considering organic causes in treating patients with mania, especially when there are unexplained neurological findings and cognitive dysfunction. The case also illustrates the usefulness of magnetic resonance imaging for investigating organic causes of secondary mania and psychosis.


1. Poser CM, Scheinberg L et al. New diagnostic criteria for multiple sclerosis. Ann Neurol 1983;13:227-231.

2. McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001;50:121-127.

3. Krauthammer C, Klerman GL. Secondary mania: manic syndromes associated with antecedent physical illness or drugs. Arch Gen Psychiatry 1978;35:1333-1339.

4. Noseworthy, JH. Medical progress: multiple sclerosis. N Engl J Med 2000;343:938-952.

5. Lau KK, Wong LKS, Li LSW, Chan YW, Li HL, Wong V. Epidemiological study of multiple sclerosis in Hong Kong Chinese: questionnaire survey. Hong Kong Med J 2002;8:77-80.

6. Shiu KL, Tsoi TH, Cheung CM, Au Yeung M, Hon FK. First demyelinating syndrome and risk of progression to multiple sclerosis in Chinese patients. Eur J Neurol 2002;9(Suppl 2):222.

7. Ron MA, Logsdail SJ. Psychiatric morbidity in multiple sclerosis: a clinical and MRI study. Psychol Med 1989;19:887-895.

8. Garland EJ. Multiple sclerosis and affective disorders. Can J Psychiatry 1991;36:112-117.

9. Fisk JD. Hospital-based psychiatric service utilization and morbidity in multiple sclerosis. Can J Neurol Sci 1998;25:230-235.

10. Pine DS. Patients with multiple sclerosis presenting to psychiatric hospitals. J Clin Psychiatry 1995;56:295-306.

11. Schiffer RB. Association between bipolar affective disorder and multiple sclerosis. Am J Psychiatry 1986;143:94-95.

12. Joffe RT. Mood disorder and multiple sclerosis. Arch Neurol 1987;44:376-378.

13. Heila H. Case study: mania associated with multiple sclerosis. J Am Acad Child Adolesc Psychiatry 1995;34:1591-1595.

14. Kellner CH. Rapid cycling bipolar disorder and multiple sclerosis. Am J Psychiatry 1984;141:112-113.

15. Monaco F. Psychotic onset of multiple sclerosis. Ital J Neurol Sci 1980;1:270-280.

16. Casanova MF. Multiple sclerosis and bipolar disorder: a case report with autopsy findings. J Neuropsychiatry Clin Neurosci 1996;8:206-208.

17. Natale E. Description of a case of multiple sclerosis with psychotic disorders at the onset. [In Italian]. Riv Neurol 1986;56:271-275.

18. Salmaggi A. Parallel fluctuations of psychiatric and neurological symptoms in a patient with multiple sclerosis and bipolar affective disorder. Ital J Neurol Sci 1995;16:551-553.

19. Das A. Organic manic syndrome: causative factors, phenomenology
and immediate outcome. J Affect Disord 1993;27:147-153.

20. Swayze VW, Andreasen NC, Alliger RJ, Ehrhardt JC, Yuh WTC.
Structural brain abnormalities in bipolar affective disorder. Arch Gen
Psychiatry 1990;47:1054-1059.

21. Robinson RG, Boston JD, Starkstein SE, Price TR. Comparison of mania and depression after brain injury: causal factors. Am J Psychiatry 1988;145:172-178.

22. Rundell JR, Wise MG. Causes of organic mood disorder. J Neuropsychiatr 1989;1:398-400.

23. Starkstein SE, Mayberg HS, Berthier ML, et al. Mania after brain injury:
neuroradiological and metabolic findings. Ann Neurol 1990;27:652-659.

24. Starkstein SE, Fedoroff P, Berthier ML, Robinson RG. Manic-depressive
and pure manic states after brain lesions. Biol Psychiatry 1991;29:

25. Jorge RE, Robinson RG, Starkstein SE, Arndt SV, Forrester AW, Geisler FH. Secondary mania following traumatic brain injury. Am J Psychiatry 1993;150:916-921.

26. Feinstein A. Psychotic illness in multiple sclerosis: a clinical and magnetic resonance imaging study. Br J Psychiatry 1992;680-685.