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Table 1: List of patients, identified in case reports, where BD preceded the onset of MS
Case Gender BD BD type Treatment; response MS MS presentation and Neuroimaging findings Reference
number onset onset course
1 Male 58 Manic Li; full resolution 58 Progressive spastic and NR [13]
episode ataxic quadriparesis
2 Female 27 Manic NS 28 R/R cervical cord MRI: lesions in centrum [14]
episode semiovale, periventricular
regions; cerebral and
cerebellar atrophy
3 Female 15 Manic APs; full resolution 15 R/R neuropsychiatric MRI: diffuse white matter [15]
episode symptoms signal intensity along
ventricles extending to
the centrum semiovale
bilaterally
4 Female 48 Manic Li + APs; significant 48 Progressive lethargy, MRI: lesions in [16]
episode improvement restlessness, difficulty periventricular and
concentrating, urinary subcortical areas, corpus
incontinence, periodic callosum, right
disorientation cerebral peduncle, right
brainstem
5 Female 54 Manic AE + AP; 54 Progressive MRI: diffuse and multifocal [17]
episode poor response neuropsychiatric lesions in cerebral
symptoms and hemispheres
cognitive impairment
6 Female 50 Manic AP; poor response 50 Progressive MRI: multiple [17]
episode neuropsychiatric punctate and patchy
symptoms and cognitive periventricular lesions,
impairment including Dawson’s finger
7 Male 20 Recurrent Li + APs; full resolution 29 Progressive unilateral CT: diffuse concentric [18]
mania at 1st episode; poor vision loss, diplopia, patchy areas
reponse subsequently paresthesia, ataxia and
gait difficulties
8 Female 50 Recurrent APs; partial response 56 Progressive ataxic MRI: lesions in centrum [14]
mania hemiparesis and semiovale, periventricular
cognitive deficits regions, thalamus;
marked frontal and
parietal atrophy
9 Female 39 Recurrent NS 41 R/R brainstem and NR [14]
mania thoracic cord
10 Female 21 Recurrent NS 37 Progressive MRI: lesions in centrum [14]
mania hemiparesis and ataxia semiovale, periventricular
regions
11 Female 42 Recurrent Li + APs; full resolution 49 Arms paraesthesias, MRI: multiple hypersignal [19]
mania ataxic gait lesions in periventricular
area, cerebellum, corpus
callosum, one large and
active lesion on right
frontal lobe with peripheral
oedema; remarkable brain
atrophy
12 Female 27 Recurrent NS 43 Left lower extremity MRI: lesions in the [20]
mania weakness and unstable periventricular and
gait subcortical areas, bilateral
centrum semiovale,
right pontine and right
cerebellar cortex
13 Female 26 BD-I RC Li + Aps + AEs; 29 Progressive ataxia, left CT: several enhancing [21]
poor response hemiparesis, intractable lesions in left parietal area,
nausea vomiting, bowel several periventricular
bladder incontinence, areas of low attenuation
bilateral Babinski
14 Female 46 BD-II RC Li + ADs; 49 Progressive ataxic gait CT: normal [21]
poor response
15 Male 23 BD-I AP; full resolution 27 Progressive ataxic gait, CT: normal [22]
blurry vision, vertical,
lateral and intermittent
rotary gaze nystagmus
16 Female 49 BD-I Li + APs; 49 R/R sensory alterations NR [22]
poor response left leg
17 Female 25 BD-I APs + Li; full resolution 30 R/R brainstem and NR [14]
at first episode; poor cervical cord
response subsequently
Contd...

196 Neuroimmunol Neuroinflammation | Volume 2 | Issue 4 | October 15, 2015 Neuroimmunol Neuroinflammation | Volume 2 | Issue 4 | October 15, 2015 197