Journal des biomarqueurs moléculaires et du diagnostic

Can We Speak About a Psychiatric Attack During a Multiple Sclerosis?

Abstract

Ben Ali N, Jamoussi H, Fray S, Kchaou M and Belal S

Introduction:Psychiatric disorders may be encountered in certain central nervous system diseases. In multiple sclerosis (MS) some of these manifestations have been described and are not necessarily related to the psychological impact of such disabling disease. The link between these disorders and MS remains incompletely determinated.

Case report: We report a case of a 31 years old women, diagnosed since March 2010 for MS. She developed two neurological episodes: retrobulbar optic neuritis and lower limb paresthesia. She fulfilled Barkhof's MRI criteria. The new episode was associated with concomitant melancholia and psychiatric symptoms. Brain magnetic resonance imaging revealed a new frontal lesion. Biological balance was normal. The diagnosis of MS attack was established. Given to treat acute episodes, high-dose corticosteroids enabled regression of the psychological fits.

Discussion: Psychiatric disorders in MS have been described since 1926. Patients may have mood disorders, personality disorders or psychosis. Thus, the occurrence of psychiatric disorder during the MS is no longer regarded as an atypical subject. They seem to occur on average one year after diagnosis of MS. More rarely, they can usher the clinical picture. The possibility of isolated "psychiatric attack" in MS cannot be excluded. Hypothesis reinforced by the good response of psychiatric symptoms to steroids and the presence of a concomitant gadolinium enhancing lesion.

Conclusion: This case report adds to those in the literature, making psychiatric disorder a possible manifestation of MS. The psychiatric symptoms-MS association may be due to local MS-related brain damage or a common genetic susceptibility.