Psychiatric disorders in the encephalitic form of multiple sclerosis

Multiple sclerosis lesions may occur predominantly in the hemispheric white matter and cause various psychiatric disorders such as remitting-relapsing endoform or exogenous psychosis, organic personality alterations and dementia. Nineteen patients suffering from this encephalitic form of multiple sclerosis as diagnosed by characteristic CSF immunoglobulin findings are analysed according to established psychopathological criteria. All cases began with psychiatric symptoms and neurological signs were either absent or overlooked. Several patients developed typical encephalomyelitic symptoms in successive relapses, but other remained with psychiatric disorders over many years. Only four patients had retrobulbar neuritis, but seven suffered from epileptic seizures. The humoral immune response was characterized by a strong dominance of IgG and a local synthesis of polyspecific antibodies against measles, rubella and varicella/zoster virus. The mononuclear CSF pleocytosis was comparatively marked with cell counts up to 180/microliter.