The spectrum of psychosis in multiple sclerosis: a clinical case series

Abstract

Psychosis in the context of multiple sclerosis (MS) has previously been reported as a rare occurrence. However, recent epidemiological studies have found prevalence rates of psychosis in MS that are two to three times higher than those in the general population. Untreated psychosis in patients with MS can adversely impact on adherence to MS medication, levels of disability, and quality of life. This retrospective case series describes the spectrum of psychotic disorders occurring in association with MS using demographic, clinical, and neuroimaging data. In the discussion, we highlight the particular diagnostic and treatment challenges that such disorders can pose for clinicians and through our case vignettes provide examples of potential interventions for this complex patient population.

Possible effects of electroconvulsive therapy on refractory psychosis in primary progressive multiple sclerosis: A case report

“…As pointed out above, psychiatric symptoms are commonly shown in MS . So far several studies have reported effects of antipsychotics on psychosis in MS . On the other hand, we verified that the psychosis in our patient with PPMS was refractory to antipsychotics, including risperidone, quetiapine, olanzapine, and asenapine.…”

“…As pointed out above, psychiatric symptoms are commonly shown in MS . So far several studies have reported effects of antipsychotics on psychosis in MS .…”

“…Common symptoms include sensory symptoms in limbs or face, unilateral visual loss, acute or subacute motor weakness, diplopia, gait disturbance and balance problems, Lhermitte sign, vertigo, bladder problems, limb ataxia, acute transverse myelitis, and pain . In addition, some degree of psychiatric symptoms is commonly shown in patients with MS . Specifically, recent epidemiological studies found that prevalence rates of psychosis in MS are two to three times higher than those in the general population .…”

“…In addition, some degree of psychiatric symptoms is commonly shown in patients with MS . Specifically, recent epidemiological studies found that prevalence rates of psychosis in MS are two to three times higher than those in the general population . Also, the risk of suicide in patients with MS may be increased in comparison with the general population .…”

Psychosis: an autoimmune disease?

“…Psychosis is also recognized, either monosymptomatically or in association with other neuropsychiatric or systemic symptoms, as a consequence of other CNS autoimmune and inflammatory disorders, including systemic lupus erythematosus, multiple sclerosis, sarcoidosis, and autoimmune vasculitides . The specific mechanisms underlying psychotic symptoms in these disorders remain largely unknown.…”