Is Susac syndrome associated with bipolar disorder?

Staelens, Clea; Audenaert, Kurt; Tandt, Hannelore; Driessche, Veroniek Van; Lemmens, Gilbert

doi:10.1016/j.clineuro.2016.07.017

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…Neuropsychiatric manifestations include mood fluctuations (16%), behavioral (15%) and personality changes (12%), apathy (12%) and psychosis (10%) (Dörr et al, 2013). The association with BD has been reported in a few cases (Assuras and Lacy, 2011;Zormann et al, 2012;Staelens et al, 2016). BD and Susac-syndrome have common neuroimaging abnormalities which might contribute to their shared clinical manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…Seeing this, the need for a full psychiatric evaluation of Susac-syndrome patients becomes evident, as mood symptoms may be attributed to an adjustment reaction or could be masqueraded during the acute encephalopathic phase. There is no clear evidence to suggest causation between the two diseases, but taking into account the low prevalence of Susac-syndrome, the common neuroanatomical changes and that high corticosteroid doses are sometimes needed, it is imperative to monitor for psychiatric symptoms (Staelens et al ., 2016).…”

Section: Discussionmentioning

confidence: 99%

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Bipolar disorder and Susac syndrome: a case report

Gutiérrez-Arango

Anmella

Hidalgo‐Mazzei

et al. 2021

International Clinical Psychopharmacology

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Susac-syndrome is a rare autoimmune disease that manifests with mood alterations in up to 15% of cases and is usually treated with corticosteroids. We present the case of a 41-year-old woman with a first manic episode and history of Susac-syndrome, secondary Cushing’s syndrome after receiving high doses of corticosteroids and a previous depressive episode. Differentiating between primary and secondary mania is difficult, as people with bipolar disorder are prone to multiple psychiatric and nonpsychiatric comorbidities, in this case, the differential diagnosis included secondary mania, corticoid-induced manic episode and primary bipolar disorder. Upon admission, corticosteroid treatment was suspended, and the patient was started on lithium and risperidone. Secondary causes of mania were discarded and, assessing temporal and dosage criteria, it was deemed unlikely that the present episode was corticosteroid-induced. One-year outpatient follow-up pointed towards a primary bipolar type I disorder, as a separate entity from her Susac-syndrome. Corticosteroid use or abrupt withdrawal pose an underestimated risk of inducing depressive or manic symptoms, which may unmask affective disorders in susceptible individuals. Many medical conditions share CNS involvement and/or high-dose/prolonged corticosteroid treatment. In such cases, psychiatric manifestations such as mania or depression should be regarded as secondary and studied to determine the existence of medical complications before considering primary psychiatric conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bipolar disorder and Susac syndrome: a case report

Gutiérrez-Arango

Anmella

Hidalgo‐Mazzei

et al. 2021

International Clinical Psychopharmacology

View full text Add to dashboard Cite

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Clinical characteristics and treatment approaches in patients with Susac syndrome: a scoping review of cases

Stinissen,

Tukanov,

Wyckmans

et al. 2023

J Neurol

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The neurocognitive and neuropsychiatric manifestations of Susac syndrome: a brief review of the literature and future directions

Koncz,

Say,

Gleason

et al. 2024

Neurol Sci

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Encephalopathy is part of the clinical triad of Susac syndrome, but a detailed understanding of the neurocognitive and neuropsychiatric profile of this condition is lacking. Existing literature indicates that cognitive deficits range in severity from subtle to profound. Executive function and short-term recall are affected frequently. Psychiatric manifestations may be absent or may include anxiety, mood disorders or psychosis. If psychiatric phenomena develop during the disease course, it can be hard to disentangle whether symptoms directly relate to the pathology of Susac syndrome or are secondary to treatment-related side effects. In this article, we review what is known about the cognitive and psychiatric morbidity of Susac syndrome and identify areas where knowledge is deficient. Importantly, we also provide a framework for future research, arguing that better phenotyping, understanding of pathophysiology, evaluation of treatments on cognitive and psychiatric outcomes, and longitudinal data capture are vital to improving patient outcomes.

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Is Susac syndrome associated with bipolar disorder?

Cited by 4 publications

References 5 publications

Bipolar disorder and Susac syndrome: a case report

Bipolar disorder and Susac syndrome: a case report

Clinical characteristics and treatment approaches in patients with Susac syndrome: a scoping review of cases

The neurocognitive and neuropsychiatric manifestations of Susac syndrome: a brief review of the literature and future directions

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