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A true isolated cognitive relapse in multiple sclerosis.

Valeria Pozzilli1, Alessandro Cruciani2, Fioravante Capone2

  • 1Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, University Campus Bio-Medico, Rome, Italy. v.pozzilli@unicampus.it.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|October 7, 2022
PubMed
Summary
This summary is machine-generated.

Isolated cognitive relapses (ICRs) in multiple sclerosis (MS) are rare but important to recognize. This case highlights a patient with sudden memory loss and confusion due to a brain lesion, emphasizing the need for prompt diagnosis and treatment of ICRs.

Keywords:
Isolated cognitive relapseMemory lossNeurophysiologyNeuropsychology

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Isolated cognitive relapses (ICRs) are debated in multiple sclerosis (MS) due to typical cognitive decline accompanying sensorimotor relapses.
  • A clear consensus on the definition and recognition of ICRs is lacking.
  • Understanding ICRs is crucial for timely intervention and management in MS patients.

Purpose of the Study:

  • To present a case study of a patient experiencing an isolated cognitive relapse.
  • To discuss the neuropsychological and neurophysiological manifestations of this rare MS entity.
  • To emphasize the importance of recognizing ICRs for prompt treatment and further research.

Main Methods:

  • Detailed neuropsychological and neurophysiological assessments were performed.
  • Neuroimaging, including gadolinium-enhanced MRI, was utilized to identify brain lesions.
  • Clinical presentation and response to treatment were monitored over time.

Main Results:

  • A patient presented with acute confusion and memory loss without sensorimotor deficits.
  • Neuroimaging revealed a large tumefactive lesion in the left medial temporal lobe.
  • Symptoms persisted for months despite corticosteroid treatment, suggesting a true ICR.

Conclusions:

  • The presented case supports the existence of isolated cognitive relapses in multiple sclerosis.
  • Clinicians should maintain a high index of suspicion for ICRs, even in the absence of typical relapse symptoms.
  • Further research into the pathophysiology of ICRs, utilizing neuropsychology and neurophysiology, is warranted.