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Psychotic reaction as a manifestation of multiple sclerosis relapse treated with plasma exchange

Tereza Gabelić1, Ivan Adamec, Anamarija Mrđen

  • 1Department of Neurology, Refferal Center for Demyelinating Diseases of the Central Nervous System, University Hospital Center Zagreb, Zagreb, Croatia.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|July 29, 2011
PubMed

Insights

A patient with multiple sclerosis experienced paranoid psychosis, a severe neurological symptom. Prompt treatment with plasma exchange led to complete recovery, highlighting psychosis as a significant, treatable manifestation of the disease.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Radiology

Background:

  • Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • Psychiatric manifestations, including psychosis, are increasingly recognized in MS patients.
  • Early diagnosis and intervention are crucial for managing MS and its associated symptoms.

Observation:

  • A patient presented with a clinically isolated syndrome (CIS) indicative of multiple sclerosis (MS).
  • The patient subsequently developed severe paranoid psychosis with suicidal ideation.
  • Brain MRI revealed four new lesions in critical areas: temporal lobes, cingulate gyrus, and midbrain tegmentum.

Findings:

  • The observed lesions were located in strategic brain regions potentially responsible for the psychotic symptoms.
  • The patient's psychosis resolved completely following treatment with plasma exchange.
  • This case suggests psychosis may be a more frequent MS symptom than previously thought.

Implications:

  • Psychosis in MS presents a significant diagnostic and therapeutic challenge.
  • Understanding the neuroanatomical basis of MS-related psychosis is vital for effective treatment.
  • Plasma exchange can be an effective treatment for acute psychotic episodes in MS patients.

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