White Matter Lesions & BipolarDisorder
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Q:  White Matter Lesions & Bipolar Disorder

I was diagnosed with bipolar disorder about seven years ago.  Four years after my diagnosis, I began having migraines and small-mal seizures.  They did an MRI and found a benign white-matter lesion in my right parietal lobe.  They never removed it because its location made surgical removal very dangerous, but they guessed that it might be either a pilocytic astrocytoma, or an oligodendroglioma.  In the past couple years I have discovered more and more research connecting white matter lesions to bipolar disorder, although my neuro-oncologist and my psychiatrist claim they are not related.  Here is an example of an article I found:
Perhaps there has not been enough studies on the subject to make any useful conclusions, but I was wondering if I were to get radiation therapy to remove this lesion, if the symptoms of bipolar could possibly be diminished.

Thank you,

Dear Ms. M' --
Although you are quite correct in your research -- yes, white matter lesions are indeed associated with bipolar disorder -- the lesion you describe does not sound like the same kind of phenomenon. Of course I can't tell that for certain without seeing the MRI, but from your description, this is very different than the "deep white matter lesions" which the paper you cite describes. That was interesting, I hadn't seen the distinction they draw between periventricular white matter lesions and these deep white matter lesions. However, in both cases, they are talking about brain changes they thing are associated with bipolar disorder.  Causing it? I doubt that, and the research has not been suggesting that (more like "caused by" bipolar disorder).  I think that may have some bearing on the question you ask, but hesitate to be more specific as this would be best handled by someone who can see that MRI and comment.  On the whole, however, from the information you present here, I find myself agreeing with your oncologist and psychiatrist.  Sorry, I'll bet that's not what you were hoping to hear...

Dr. Phelps. 

Published November, 2005


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