Esclerosis múltiple y episodio psicótico maniforme: reporte de un caso.

Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, of multifactorial etiology, which can begin at any age, but preferably between 20 and 40 years. It is manifested by various neurological and psychiatric symptoms. Psychiatric manifestations may be an expression of a psychiatric disorder itself, a disorder due to MS, a disorder reactive to its somatic and functional consequences and/or an adverse effect of treatment; It is often difficult to clarify its pathogenesis. Depression and anxiety are the psychiatric conditions with the highest prevalence in people with MS. Less frequent are psychosis (less than 4%) and mania (less than 6%). The findings for psychosis are still inconclusive and further studies are required. The clinical case of a 60-year-old patient, diagnosed with Progressive MS at age 59, is presented. About 10 years earlier he had started with changes in his personality and functioning, then distressing symptoms and physical decay. Six months before diagnosis, neurological signs began and a year after starting these, psychotic symptoms were added that progressively intensified and diversified over the course of six months, severely compromising its functioning and requiring psychiatric hospitalization. It was treated with atypical neuroleptics. Its probable onset with psychiatric manifestations and differential psychiatric diagnosis is discussed. It is estimated to be a maniform psychotic disorder due to MS and highlights the importance of preventive measures to improve the timeliness of diagnosis.