Psychotic reaction as a manifestation of multiple sclerosis relapse treated with plasma exchange

Abstract

We present a patient with a clinically isolated syndrome suggestive of multiple sclerosis, who developed a full-blown picture of paranoid psychosis with suicidal attempt. Four new lesions were observed on brain MRI, one in the left and one in the right temporal lobe, one subcortically in the cingulate gyrus and one centrally in the tegmentum of the midbrain. The patient was treated with plasma exchange and recovered completely. Psychosis is not so rare symptom of multiple sclerosis as previously reported, and poses a major treatment challenge. A combination of lesions at strategic locations was a presumed mechanism of psychosis in this patient.

Umbilical cord blood-based gene signatures related to prenatal major depressive disorder: Retracted

“…[21] Psychosis is regarded as a well-known symptom in multiple sclerosis (MS), an autoimmune disease, especially in those patients with lesions in the periventricular white matter area. [22] Dickens [23] considered depression was more common in people with chronic inflammatory diseases such as rheumatoid arthritis. Benros [24] reported a dose-response relationship between serious infection during childhood and risk of psychotic disorders after adulthood.…”

Brain anomalies in early psychosis: From secondary to primary psychosis

“…As previously stated, encephalitic lesions may often not be seen on MRI, but in front of a normal MRI, its repeat after some weeks could highlight their possible delayed appearance (K. Shah et al 2013). Other delusional manifestations have revealed the inflammatory lesions of a relapse in multiple sclerosis (Gabelić et al 2012;Yadav and Zigmond 2010), the onset of acute disseminated encephalomyelitis (Nasr, Andriola, and Coyle 2000), a herpetic encephalitis (Zabroug et al 2015), or a neuro-Behçet disorder (Deniz et al 2009). A left temporal lobe tumor, suspected to be a low-grade glioma, has also been described in a young adult with classical psychotic symptomatology (Shehane et al 2018).…”