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Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
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Psychosis: a rare onset symptom of pediatric multiple sclerosis

Pınar Özbudak1, Hakan Erçelebi1, Kıvılcım Gücüyener1

  • 1Department of Pediatrics, Division of Child Neurology, Gazi University Medical School, Ankara, Turkey.

Neurocase
|December 20, 2021
PubMed

Insights

Psychosis can be an initial symptom of pediatric multiple sclerosis (MS). Early diagnosis and treatment of MS in children presenting with neuropsychiatric symptoms are crucial to prevent long-term disability.

Area of Science:

  • Neuroimmunology
  • Pediatric Neurology

Background:

  • Neuropsychiatric symptoms, including psychosis, are infrequent initial presentations of multiple sclerosis (MS).
  • Pediatric MS requires careful consideration in differential diagnoses for children with unexplained neurological and psychiatric symptoms.

Observation:

  • A 14-year-old male presented with auditory hallucinations and a normal neurological exam.
  • Brain MRI revealed demyelinating lesions in the mesencephalon and periventricular regions, with elevated IgG index and positive oligoclonal bands, confirming MS diagnosis.

Findings:

  • Initial treatment with pulsed corticosteroids led to the regression of psychotic symptoms.
  • A subsequent presentation with hemi-hypoesthesia and new MRI lesions 22 months later also resolved with corticosteroid therapy.

Implications:

  • This case highlights the importance of considering MS in the differential diagnosis of pediatric psychosis.
  • Delayed diagnosis and treatment of MS in pediatric patients can increase morbidity, emphasizing the need for prompt neuroimaging and cerebrospinal fluid analysis.
Keywords:
Childhoodadolescentmultiple sclerosisneuropsychiatrypsychosis

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