Mental change as an early feature of multiple sclerosis

Area of Science:

• Neurology
• Neuroimmunology
• Psychiatry

Background:

• Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Clinical presentation of MS is highly variable, often including neurological deficits.
• Early diagnosis of MS is crucial for timely intervention and management.

Purpose of the Study:

• To report on five patients presenting with significant mental changes as an early symptom of an illness resembling multiple sclerosis.
• To investigate the association between early-onset mental changes and brainstem involvement in suspected MS cases.
• To emphasize the potential for psychological alterations to be a primary manifestation of insidious multiple sclerosis.

Main Methods:

• Case series reporting on five patients.
• Clinical assessment focusing on neurological signs, particularly brainstem involvement.
• Cerebrospinal fluid (CSF) analysis for diagnostic markers.

Main Results:

• All five patients exhibited prominent mental changes as an early feature.
• Clinical signs pointed towards predominant brainstem involvement in all cases.
• Cerebrospinal fluid findings were consistent across the reported patients.

Conclusions:

• Mental changes can be a significant and early presenting symptom of multiple sclerosis.
• The presence of early mental changes does not exclude MS, especially in insidious cases.
• Brainstem involvement and characteristic CSF findings support MS diagnosis even with atypical early symptoms.