Psychiatric event in multiple sclerosis: could it be the tip of the iceberg?

摘要: Multiple sclerosis (MS) is a chronic progressive inflammatory disease of the central nervous system. Psychiatric comorbidities are highly prevalent in patients with MS, and can have drastic impact on quality life interpersonal relationships. Despite this high prevalence, whether psychiatric manifestations may represent first signs MS still debatable. This constitutes an important issue, since early diagnosis "psychiatric-onset MS" would result prompt management, which usually ameliorates long-term prognosis. Here, we discuss clinical radiological hints that suggest psychiatric-onset MS. Briefly, entity should be considered healthy presenting late-onset symptoms, or without cognitive decline, negative family history diseases. A thorough neurological exam crucial to detect any subtle signs. Brain magnetic resonance imaging recommended rule out frontotemporal lesions might explain picture. Poor response standard treatments provides additional evidence for organic (e.g., MS). Combining psychopharmaceuticals intravenous corticosteroids good outcomes, but monitored carefully possible exacerbation, common side effect steroids.