Department of Neurosciences, University of Modena and Reggio Emilia, Baggiovara, Italy.
Neurol Sci. 2011 Aug;32(4):695-7. doi: 10.1007/s10072-011-0581-9. Epub 2011 Apr 16.
We report the case of a woman who started complaining of depression, attention and memory problems at the age of 49. Over the following 6 years, serial neuropsychological assessments showed fluctuating, but overall progressively worsening, performances in tests exploring attention, working memory, language and executive functions. Cerebrospinal fluid (CSF) examination showed identical IgG oligoclonal bands in serum and CSF. Neurological examination, to date, only reveals minimal pyramidal and cerebellar signs. Although typical clinical and laboratory evidence indicating a diagnosis of multiple sclerosis (MS) in this patient is lacking, an extensive diagnostic work-up ruled out many other causes of leukoencephalopathy and neuroradiological features strongly suggest this diagnosis. Multiple sclerosis may present with cognitive or neuropsychiatric symptoms; this should be kept in mind, especially in younger patients, even in the absence of "classical" physical symptoms.
我们报告了一例女性病例，她在 49 岁时开始抱怨抑郁、注意力和记忆力问题。在接下来的 6 年中，一系列神经心理学评估显示，在测试注意力、工作记忆、语言和执行功能的测试中，表现波动，但总体上逐渐恶化。脑脊液（CSF）检查显示血清和 CSF 中存在相同的 IgG 寡克隆带。迄今为止，神经系统检查仅显示轻微的锥体束和小脑征。尽管该患者缺乏提示多发性硬化症（MS）的典型临床和实验室证据，但广泛的诊断检查排除了许多其他脑白质病的病因，神经影像学特征强烈提示这一诊断。多发性硬化症可能表现为认知或神经精神症状；特别是在年轻患者中，即使没有“典型”的躯体症状，也应考虑到这一点。
