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Psychiatric presentation of disseminated encephalomyelitis and multiple sclerosis (CROSBI ID 740110)

Prilog sa skupa u časopisu | izvorni znanstveni rad

Habek, Mario ; Brinar, Marko ; Brinar, Vesna Psychiatric presentation of disseminated encephalomyelitis and multiple sclerosis // European journal of neurology. 2005. str. 130-x

Podaci o odgovornosti

Habek, Mario ; Brinar, Marko ; Brinar, Vesna

engleski

Psychiatric presentation of disseminated encephalomyelitis and multiple sclerosis

Background: It is unusual for acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) to present as purely psychiatric disorders. We present 5 patients with ADEM or MS and symptoms of psychosis, depression or anxiety. Case reports: First two patients presented as a new-onset psychosis, with cognitive impairment in patient 2. Brain MRI in both cases revealed large areas of increased signal intensity on T2-weighted images, a finding characteristic for ADEM. CSF analysis showed intratecal gamma globulin synthesis with positive oligoclonal bands. A 53 year old MS patient developed paranoid psychosis and persecutory delusions. Brain MRI revealed two demyelinating lesions in right parietal cortex with gadolinium enhancement. Patient 4 developed symptoms of major depression after childbirth. Brain MRI revealed multifocal demyelinating lesions and oligoclonal bands were positive. Patient 5 had symptoms of generalized anxiety disorder and was diagnosed with postinfectious ADEM. Discussion: Data from our patients are highly suggestive of a causative link between demyelination and psychiatric symptoms. First three patients presented with predominantly psychiatric symptoms and had MRI and CSF findings which pointed to the ADEM or MS. Similarly, subcortical white matter lesions in patient 4 are in concordance with previous findings that cortical-subcortical disconnection is responsible for depression in demyelinating disorders. Although in many patients anxiety is merely a reactive response to the diagnosis, clinical picture of patient 5 is suggestive of connection between anxiety symptoms and MS. Conclusion: These cases highlight the fact that significant proportion of all psychiatric patients has underlying demyelination requiring specific diagnostic work-up and therapy.

Disseminated encephalomyelitis; Multiple sclerosis; Psychosis; Depression; Generalized anxiety disorder

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Podaci o prilogu

130-x.

2005.

nije evidentirano

objavljeno

Podaci o matičnoj publikaciji

European journal of neurology

1351-5101

Podaci o skupu

Nepoznat skup

ostalo

29.02.1904-29.02.2096

Povezanost rada

Kliničke medicinske znanosti

Indeksiranost