[Psychotic symptoms as the initial manifestation of multiple sclerosis?]

Five case reports with psychiatric disorders prior to the diagnosis of multiple sclerosis are presented and discussed in relation to relevant scientific literature. Particularly the possibility of a causal correlation between psychopathological abnormalities and the CNS-inflammation is investigated. According to several reports and the own observations one has to consider the possibility of a (pure) psychotic onset of multiple sclerosis. The differential diagnosis in patients with psychotic illness should therefore include the encephalitic form of MS. Further studies with a standardized setting and a definite population basis are necessary to expand the knowledge in the epidemiology of psychiatric disturbances in MS.