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[Inaugural psychotic events in multiple sclerosis?]
1Service de neuropsychologie, département de neurologie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France. blanc.frdrc@free.fr
Revue Neurologique
|September 9, 2009
Summary
Psychotic symptoms can be an early indicator of multiple sclerosis (MS), a neurological disease. Early diagnosis and psychiatric treatment are crucial for managing these initial MS manifestations.
Area of Science:
- Neuroscience
- Psychiatry
- Neurology
Background:
- Psychotic symptoms are often overlooked in early multiple sclerosis (MS).
- This study highlights the potential of psychiatric manifestations as a presenting sign of MS.
Observation:
- Four patients developed psychotic symptoms, leading to their MS diagnosis.
- Symptoms included persecutory delusions, mania, and melancholia with catatonia.
- Cerebrospinal fluid showed oligoclonal bands, and MRI met Barkhof criteria in all patients.
Findings:
- Frontal lobe lesions were observed on MRI in three patients during psychotic episodes.
- One patient with catatonia also had cerebellar and brainstem lesions.
- All patients required psychiatric treatment, including antipsychotics, with symptom duration varying.
Implications:
- Acute psychiatric symptoms can herald the onset of multiple sclerosis.
- Frontal lobe involvement may be associated with these initial psychotic events.
- Psychotic episodes could represent active inflammatory events in MS.
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