Noorani Nahid, Hadi Fateme, Ahmadkhaniha Hamid Reza
M.D., Psychiatrist, Tehran, Iran.
M.D., Assistant Professor of Psychiatry, Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
Electron Physician. 2016 Dec 25;8(12):3409-3411. doi: 10.19082/3409. eCollection 2016 Dec.
Multiple sclerosis (MS) is the most common debilitating neurological disease that affects adults, whether young adults or middle-aged. Although, most attention is toward the neurological signs of the disease, the neuropsychiatric signs are not uncommon. This case report presents a 29 year old male with a record of obsessive-compulsive disorder (OCD) without psychotic disorder, which coincides with the diagnosis MS, has been stricken to auditory hallucinations and reference delusion. The patient received some antipsychotic drugs such as Haloperidol and Perphenazine irregularly, but any psychotic signs of the patient were never in control. During this period he had several active episodes of MS disease, wherein the symptoms had subsided due to hospitalization and received corticosteroids pulse. The first time the patient was submitted to the emergency unit of Rasoul Akram Hospital, there was the possibility of schizophrenia which was confirmed in subsequent visits. The signs of the patient were not controllable for a long time and finally fully controlled by a combination of Aripiprazole (abilizol), Risperidone and Sertraline, and currently, for almost 3 years, both psychotic symptoms and MS disease have been under control. Our patient seems to catch the MS disease and schizophrenia simultaneously. There was no relation between MS and psychosis episodes and the MS attacks. Since the onset the patient had several acute MS attacks of MS, and hospitalization several times. These findings and characteristics regarding our patient made him completely different from other reported cases of MS along with neuropsychiatric signs which may help doctors in diagnosis and managment of similar cases.
多发性硬化症(MS)是影响成年人(无论是年轻人还是中年人)的最常见的使人衰弱的神经系统疾病。尽管大多数注意力都集中在该疾病的神经学体征上,但神经精神学体征也并不罕见。本病例报告介绍了一名29岁男性,有强迫症(OCD)病史且无精神障碍,在被诊断为MS时,出现了幻听和关系妄想。该患者曾不定期服用一些抗精神病药物,如氟哌啶醇和奋乃静,但患者的任何精神病性体征都从未得到控制。在此期间,他有几次MS疾病的活动发作,因住院并接受皮质类固醇脉冲治疗,症状有所缓解。患者首次被送往拉苏勒·阿克拉姆医院急诊科时,有可能患有精神分裂症,后续就诊得以确诊。患者的体征长期无法控制,最终通过阿立哌唑(安律凡)、利培酮和舍曲林联合使用得到完全控制,目前,近3年来,精神病性症状和MS疾病均得到控制。我们的患者似乎同时患上了MS疾病和精神分裂症。MS与精神病发作和MS发作之间没有关联。自发病以来,患者有几次MS的急性发作,并多次住院。关于我们患者的这些发现和特征使他与其他报道的伴有神经精神学体征的MS病例完全不同,这可能有助于医生诊断和管理类似病例。