An 81-year-old woman with postmenopausal onset of a bipolar disorder had
multiple individual manic and depressive episodes over the span of 31
years. Autopsy disclosed widespread periventricular demyelinated plaques.
Although the late age at onset of bipolar symptoms suggested an underlying
organic disorder, the multiple affective episodes and lack of additional
neurological manifestations make the case atypical. The authors stress the
use of modern imaging modalities such as MRI in investigating secondary