The Differential Diagnosis of Multiple Sclerosis and Bipolar Disorder

Letter to the Editor

Sir: Pine et al. described a series of patients hospitalized
for mania who were also found to have multiple sclerosis, thus
reminding us of the importance of considering multiple sclerosis
in patients presenting with psychiatric symptoms plus neurologic
abnormalities. We present a case illustrative of this
point, yet raise the issue that magnetic resonance imaging
(MRI) findings, commonly used to differentiate bipolar disorder
from multiple sclerosis, are similar for both disorders. This
complicates diagnosis and points to a similar etiology for
symptoms that overlap both bipolar illness and multiple sclerosis.