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Letters   |    
Three Decades of Drift: The Misdiagnosis of Predominantly Neuropsychiatric Multiple Sclerosis
João Passos, M.D.; Ana Azevedo, M.D.; Duarte Salgado, M.D.; Hipólito Nzwalo, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E55-E56. doi:10.1176/appi.neuropsych.13030063
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Neurology
Instituto Português de Oncologia de Lisboa, Francisco Gentil
Lisboa, Portugal

Neurology
Centro Hospitalar do Algarve
Faro, Algarve
Portugal

Correspondence: Dr. Nzwalo; e-mail: nzwalo@gmail.com

Copyright © 2014 by the American Psychiatric Association

Extract

To the Editor: Neuropsychiatric disturbances, such as behavior, mood, and personality changes, are often recognized during multiple sclerosis (MS) evolution.1 Psychiatric presentation and dominant cognitive MS is very rarely reported, and occurs in less than 1% of cases.2 In this report, we describe a case of MS with predominant cognitive and psychiatric manifestations from the beginning, misdiagnosed as a pure psychiatric disorder for more than three decades.

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FIGURE 1. [A]: Sagittal T2-Weighted Brain MRI Showing Multiple Hyperintense Lesions in the Corpus Callosum and the “Dawson's Fingers” (blue arrows); [B]: Axial T1-Weighted MRI Showing Hypointense Lesions, the “Black Holes” (red arrows)

FIGURE 2. Clinical Evolution With Episodes of Transient Neurological Symptoms
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References

Diaz-Olavarrieta  C;  Cummings  JL;  Velazquez  J  et al:  Neuropsychiatric manifestations of multiple sclerosis.  J Neuropsychiatry Clin Neurosci 1999; 11:51–57
[PubMed]
 
Jongen  PJ:  Psychiatric onset of multiple sclerosis.  J Neurol Sci 2006; 245:59Y62
 
Lyoo  IK;  Seol  HY;  Byun  HS  et al:  Unsuspected multiple sclerosis in patients with psychiatric disorders: a magnetic resonance imaging study.  J Neuropsychiatry Clin Neurosci 1996; 8:54–59
[PubMed]
 
Amato  MP;  Langdon  D;  Montalban  X  et al:  Treatment of cognitive impairment in multiple sclerosis: position paper.  J Neurol 2013; 260:1452–1468
[CrossRef] | [PubMed]
 
Zarei  M;  Chandran  S;  Compston  A  et al:  Cognitive presentation of multiple sclerosis: evidence for a cortical variant.  J Neurol Neurosurg Psychiatry 2003; 74:872–877
[CrossRef] | [PubMed]
 
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