Metachromatic leukodystrophy presenting as bipolar disorder.

The article describes the case of a 31-year-old man with a history of depression and episodes of disinhibition and a provisional diagnosis of bipolar disorder. He had a history of head injury at aged 17 and cognitive and neuropsychiatric assessment showed memory and executive dysfunction. Magnetic Resonance Imaging (MRI) revealed metachromatic leukodystrophy (MLD), a lysosomal storage disorder, which usually shows psychotic symptoms in adults from progressive executive defects to dementia.