Engler F, Vetter P
Abteilungen Neurologie und Psychiatrie, Uni-Klinikums Kiel.
Schweiz Arch Neurol Psychiatr (1985). 1991;142(4):367-78.
Based on reports of three cases, the manic, depressive, schizophrenic and organic mental symptoms coincident to multiple sclerosis (MS) are described. The literature indicates an increased prevalence of psychiatric disturbances in MS. However, the relation between the psychiatric and the neurological disorders remains speculative. The temporal covariance and responsiveness to pharmacotherapy of the psychiatric and neurological symptoms of MS as well as the localisation of MS foci in diagnostic procedures (CT, MRI) are discussed in the light of the literature. The present authors hypothesize that every disturbance of the central nervous system (CNS), especially if chronic-inflammatory and multilocal, increases the probability that psychiatric symptoms will arise (as measured on a continuum ranging from "psychically conspicuous" to "psychically inconspicuous"). To this extent, then, MS would be comparable to other chronic-inflammatory CNS disorders such as AIDS, neuroborrelioses, syphilis and certain forms of viral encephalitis.
基于三例病例报告,描述了与多发性硬化症(MS)同时出现的躁狂、抑郁、精神分裂症及器质性精神症状。文献表明MS患者中精神障碍的患病率有所增加。然而,精神疾病与神经疾病之间的关系仍具有推测性。结合文献讨论了MS精神症状与神经症状的时间协变性及对药物治疗的反应性,以及在诊断程序(CT、MRI)中MS病灶的定位。本文作者推测,中枢神经系统(CNS)的每一次紊乱,尤其是慢性炎症性和多灶性的紊乱,都会增加出现精神症状的可能性(以从“明显精神症状”到“不明显精神症状”的连续体来衡量)。就此而言,MS可与其他慢性炎症性CNS疾病相比较,如艾滋病、神经莱姆病、梅毒及某些形式的病毒性脑炎。