Department of Neurology, Refferal Center for Demyelinating Diseases of the Central Nervous System, University Hospital Center Zagreb, Zagreb, Croatia.
Neurol Sci. 2012 Apr;33(2):379-82. doi: 10.1007/s10072-011-0712-3. Epub 2011 Jul 28.
We present a patient with a clinically isolated syndrome suggestive of multiple sclerosis, who developed a full-blown picture of paranoid psychosis with suicidal attempt. Four new lesions were observed on brain MRI, one in the left and one in the right temporal lobe, one subcortically in the cingulate gyrus and one centrally in the tegmentum of the midbrain. The patient was treated with plasma exchange and recovered completely. Psychosis is not so rare symptom of multiple sclerosis as previously reported, and poses a major treatment challenge. A combination of lesions at strategic locations was a presumed mechanism of psychosis in this patient.
我们报告了 1 例临床孤立综合征疑似多发性硬化症患者，该患者发展为完全偏执型精神病并企图自杀。脑部 MRI 观察到 4 个新病灶，1 个位于左侧颞叶，1 个位于右侧颞叶，1 个位于扣带回皮质下，1 个位于中脑被盖中央。患者接受了血浆置换治疗，完全康复。精神病并不像之前报道的那样罕见，这给治疗带来了巨大挑战。在这个患者中，推测精神病的发病机制是由于病灶位于重要位置的组合。
