[Disseminated encephalomyelitis--a mask for conversion neurosis?].

A female patient, aged 24 years, with a case history of 9 years duration, 4 admissions to a neurological and 3 to a psychiatric ward was first diagnosed as multiple sclerosis. Diagnosis was based on neurological symptoms, whereas repeated laboratory values, electrophysiological measurements, CT and MRI scans were equivocal. Nevertheless this initial diagnosis profoundly influenced the further course of the illness: the patient ending up with an invalidity-pension. At that period she was admitted for her first psychiatric hospitalization after attempted suicide. Extensive investigations led to revision of the former diagnosis and Adlerian psychotherapy effected a remission of practically all neurological symptoms, so that the woman could be reintegrated socially and in her profession. Differential-diagnosis of multiple sclerosis is revised and the necessity of extensive, also psychodynamic, case-investigation is stressed, as is the need of consequent psychotherapy effected by a medical therapist.