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The neuropsychiatry of multiple sclerosis
1Neurobehavior Unit, VA Medical Center West, Los Angeles, USA.
Objective:
This article examines the cognitive and psychiatric features of multiple sclerosis. MS can manifest as a neuropsychiatric disturbance even in the absence of physical disabilities.
Method:
Two MS patients with predominant behavioral symptoms are described, and the literature is reviewed.
Results:
The first patient had an interhemispheric disconnection syndrome, and the second patient had cognitive fatigue and depression. Other patients have slowed information processing speed, memory retrieval difficulty, frontal-executive dysfunction, and visuospatial difficulty.
Conclusions:
MS results in specific cognitive deficits and mood disorders. These two patients had organic mental disorders from cerebral demyelination particularly affecting the corpus callosum. Our patients have neuropsychiatric symptoms from extensive demyelination of prefrontal-subcortical circuits. Evaluation and management strategies are discussed.