From perimenopause to neuroinflammation: Rethinking a case of late‐onset mania
Zaid Nathani, Helene Alphonso · 2026
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Description
Zaid Nathani and Helene Alphonso present a 2026 case report about a 46-year-old woman whose first manic episode was read at first as late-onset bipolar disorder. Her perimenopausal symptoms and a decade of stability on an antidepressant shaped that early reading. Months later she developed painless leg weakness and needed a wheelchair, yet spine imaging looked normal, so clinicians suspected conversion disorder.
Brain imaging plus a neurologic workup eventually pointed to primary progressive multiple sclerosis behind both the mania and the weakness. The authors argue that new mania in perimenopausal women calls for a brain MRI and an autoimmune blood panel before a primary psychiatric label is settled. Their case shows how a hormone-based explanation can delay the search for a hidden neurologic illness.
Catalog record
| CREATOR | Zaid Nathani, Helene Alphonso |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 17970 |
| LICENSE | https://creativecommons.org/licenses/by/4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |