Carlos R Camara-Lemarroy1, Beatriz E Ibarra-Yruegas2, Rene Rodriguez-Gutierrez3, Idanis Berrios-Morales4, Carolina Ionete4, Peter Riskind4. 1. Neurology Service. University Hospital, "Dr. Jose E. Gonzalez", Autonomous University of Nuevo Leon, Monterrey, Mexico. Electronic address: crcamara83@hotmail.com. 2. Neurology Service. University Hospital, "Dr. Jose E. Gonzalez", Autonomous University of Nuevo Leon, Monterrey, Mexico. 3. Division of Endocrinology, University Hospital "Dr. Jose E. Gonzalez", Autonomous University of Nuevo Leon, Monterrey, Mexico; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA. 4. Department of Neurology, Multiple sclerosis Center, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
Abstract
OBJECTIVES: Multiple Sclerosis (MS) is known to be associated with a wide range of psychiatric symptoms, particularly with affective disorders. However, a link to psychotic disorders has not been fully established. METHODS: A systematic review of the PubMed/MEDLINE database was performed to identify cases of MS presenting with psychotic symptoms. Variables analyzed included patient demographics, clinical presentation, imaging characteristics and treatment. RESULTS: Ninety-one cases were identified. The mean age was 34.4, and there was a female predominance. The majority of patients did not have a prior history of MS or psychiatric disease. The majority of cases could be classified as having either Psychotic Disorders or Mood Disorders with psychotic features. Most patients received some type of antipsychotic therapy, with variable success. At least 26 patients were treated with corticosteroids in the acute phase of their psychotic symptoms, and the majority responded favorably. Imaging data was available for 50 patients. Of these, 60% had predominantly fronto-temporal lesions, and most had contrast enhancing lesions. CONCLUSIONS: MS can present with a variety of psychotic symptoms. The presence of enhancing lesions and steroid-responsiveness suggests these could be characterized as flares.
OBJECTIVES:Multiple Sclerosis (MS) is known to be associated with a wide range of psychiatric symptoms, particularly with affective disorders. However, a link to psychotic disorders has not been fully established. METHODS: A systematic review of the PubMed/MEDLINE database was performed to identify cases of MS presenting with psychotic symptoms. Variables analyzed included patient demographics, clinical presentation, imaging characteristics and treatment. RESULTS: Ninety-one cases were identified. The mean age was 34.4, and there was a female predominance. The majority of patients did not have a prior history of MS or psychiatric disease. The majority of cases could be classified as having either Psychotic Disorders or Mood Disorders with psychotic features. Most patients received some type of antipsychotic therapy, with variable success. At least 26 patients were treated with corticosteroids in the acute phase of their psychotic symptoms, and the majority responded favorably. Imaging data was available for 50 patients. Of these, 60% had predominantly fronto-temporal lesions, and most had contrast enhancing lesions. CONCLUSIONS:MS can present with a variety of psychotic symptoms. The presence of enhancing lesions and steroid-responsiveness suggests these could be characterized as flares.
Authors: Tim W Rattay; Pascal Martin; Debora Vittore; Holger Hengel; Idil Cebi; Johannes Tünnerhoff; Maria-Ioanna Stefanou; Jonatan F Hoffmann; Katrin von der Ehe; Johannes Klaus; Julia Vonderschmitt; Matthias L Herrmann; Paula Bombach; Hazar Al Barazi; Lena Zeltner; Janina Richter; Klaus Hesse; Kathrin N Eckstein; Stefan Klingberg; Dirk Wildgruber Journal: Sci Rep Date: 2021-03-30 Impact factor: 4.379