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Thirty multiple sclerosis patients were assessed: 15 with predominantly cerebral involvement of their demyelinating disease and 15 with predominantly spinal cord and cerebellar involvement. The groups were matched with regard to age, duration of illness, and Kurtzke disability scores. Assessment included neuropsychological testing, the Beck Depression Inventory, and a psychiatric interview patterned after the Schedule for Affective Disorders and Schizophrenia. A group of normal volunteers served as controls for the neuropsychological testing. There were significantly more major depressive episodes in the cerebral group, as assessed by the patients' histories and by interview, and there was a trend toward more depressive symptoms in this group, as measured by the Beck inventory.

The authors describe a patient with the neuroleptic malignant syndrome whose excessive catecholamine excretion indicates hyperactivity of the sympathoadrenomedullary component of the autonomic nervous system. Their finding provides a physiological basis for using catecholamine blocking agents to treat some patients with this syndrome.

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