Skip to main content
SpringerLink
Log in

Psychiatric disorders in the encephalitic form of multiple sclerosis

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

Multiple sclerosis lesions may occur predominantly in the hemispheric white matter and cause various psychiatric disorders such as remitting-relapsing endoform or exogenous psychosis, organic personality alterations and dementia. Nineteen patients suffering from this encephalitic form of multiple sclerosis as diagnosed by characteristic CSF immunoglobulin findings are analysed according to established psychopathological criteria. All cases began with psychiatric symptoms and neurological signs were either absent or overlooked. Several patients developed typical encephalomyelitic symptoms in successive relapses, but other remained with psychiatric disorders over many years. Only four patients had retrobulbar neuritis, but seven suffered from epileptic seizures. The humoral immune response was characterized by a strong dominance of IgG and a local synthesis of polyspecific antibodies against measles, rubella and varicella/zoster virus. The mononuclear CSF pleocytosis was comparatively marked with cell counts up to 180/μl.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bauer HJ, Argyrakis A (1982) Enzephalitische Formen der Multiplen Sklerose. In: Mertens HG, Dommasch D (eds) Encephalitis, perimed, Erlangen, pp 204–208

    Google Scholar 

  2. Bergin JD (1957) Rapidly progressing dementia in disseminating sclerosis. J Neurol Neurosurg Psychiatry 20:285–292

    Google Scholar 

  3. Brierley JB, Corsellis JAN, Hierons R, Nevin S (1960) Subacute encephalitis of later adult life mainly affecting the limbic areas. Brain 83:357–368

    Google Scholar 

  4. Caroll M, Gares R, Roldan F (1984) Memory impairment in multiple sclerosis. Neuropsychologia 22:297–302

    Google Scholar 

  5. Dickschas A, Benos J (1975) Schizophrenieähnliche Funktionspsychose bei Encephalomyelitis disseminata. Nervenarzt 46:325–327

    Google Scholar 

  6. Drake ME (1984) Acute paranoid psychosis in multiple sclerosis. Psychosomatics 25:60–65

    Google Scholar 

  7. Felgenhauer K (1971) Vergleichende Disc-Elektrophorese von Serum und Liquor cerebrospinalis. Thieme, Stuttgart

    Google Scholar 

  8. Felgenhauer K (1982) Differentiation of the humoral immune response in inflammatory diseases of the central nervous system. J Neurol 228:223–237

    Google Scholar 

  9. Felgenhauer K (1988) Liquordiagnostik. In: Thomas L (ed) Labor und Diagnose. Medizinische Verlagsgesellschaft, Marburg, pp 1403–1422

    Google Scholar 

  10. Felgenhauer K (1988) Prozeßlokalisation, Krankheitsphase und Liquorzusammensetzung. In: Holzgraefe M, Reiber H, Felgenhauer K (eds) Labordiagnostik von Erkrankungen des Nervensystems. perimed, Erlangen, pp 84–92

    Google Scholar 

  11. Felgenhauer K, Schädlich HJ (1987) The compartmental IgM and IgA response within the central nervous system. J Neurol Sci 77:125–135

    Google Scholar 

  12. Felgenhauer K, Nekic M, Ackermann R (1982) The demonstration of locally synthesized herpes simplex IgG antibodies in CSF by a sepharose 4B linked enzyme immunoassay. J Neuroimmunol 3:149–158

    Google Scholar 

  13. Felgenhauer K, Schädlich HJ, Nekic M, Ackermann R (1985) Cerebrospinal fluid virus antibodies. A diagnostic indicator for multiple sclerosis? J Neurol Sci 71:291–299

    Google Scholar 

  14. Filley CM, Heaton RK, Nelson LM, Burks JS, Franklin GM (1989) A comparison of dementia in Alzheimer's disease and multiple sclerosis. Arch Neurol 46:157–161

    Google Scholar 

  15. Grant J, McDonald WJ, Trimble MR, Smith E, Reed R (1984) Deficient learning and memory in early and middle phases of multiple sclerosis. J Neurol Neurosurg Psychiatry 47:250–255

    Google Scholar 

  16. Haas J, Woelk LS, Stark E, Maciossek E (1988) Results of a six year neuropsychological retest investigation in multiple sclerosis and changes in nuclear magnetic resonance tomography. In: Confavreux C (ed) Trends in European multiple sclerosis research. Excerpta Medica, Amsterdam, pp 339–343

    Google Scholar 

  17. Himmelhoch J, Pincus J, Tucker G, Detre T (1970) Sub-acute encephalitis: behavioural and neurological aspects. Br J Psychiatry 116:531–538

    Google Scholar 

  18. Lüer W, Poser S, Weber T, Jürgens S, Eichenlaub D, Pohle HD, Felgenhauer K (1988) Chronic HIV Encephalitis. I. Cerebrospinal fluid diagnosis. Klin Wochenschr 66:21–25

    Google Scholar 

  19. Matthews WB (1979) Multiple sclerosis presenting with acute remitting psychiatric symptoms. J Neurol Neurosurg Psychiatry 42:859–863

    Google Scholar 

  20. Mur J, Kümpel G, Dostal S (1966) An anergic phase of disseminated sclerosis with psychotic course. Confin Neurol 28:37–49

    Google Scholar 

  21. Piesiur-Strehlow B, Poser S, Felgenhauer K (1988) Paranoid-halluzinatorische Psychose als Manifestation einer Multiplen Sklerose. Nervenarzt 59:621–623

    Google Scholar 

  22. Reiber H (1988) Aktuelle Methoden der Liquoranalytik. Lab Med 12:101–109

    Google Scholar 

  23. Reiber H, Felgenhauer K (1987) Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system. Clin Chim Acta 163:319–328

    Google Scholar 

  24. Ron MA (1986) Multiple sclerosis: psychiatric and psychometric abnormalities. J Psychosom Res 30:3–11

    Google Scholar 

  25. Schädlich HJ, Felgenhauer K (1985) Diagnostic significance of IgG-synthesizing activated B cells in acute inflammatory diseases of the central nervous system. Klin Wochenschr 63:505–510

    Google Scholar 

  26. Schiffer RB, Babigian HM (1984) Behavioral disorders in multiple sclerosis, temporal lobe epilepsy, and amyotrophic lateral sclerosis. Arch Neurol 41:1067–1069

    Google Scholar 

  27. Schipper HI, Kruse H, Reiber H (1985) Isoelektrische Fokussierung des Liquor cerebrospinalis. In: Schmidt RM (ed) Der Liquor cerebrospinalis, Thieme, Leipzig, pp 505–533

    Google Scholar 

  28. Steller U, Beck U (1987) Durchgangssyndrom als Frühsymptom einer Multiplen Sklerose. Kernspintomographische und testpsychologische Fallstudie. Nervenarzt 58:256–260

    Google Scholar 

  29. Surridge D (1969) An investigation into some psychiatric aspects of multiple sclerosis. Br J Psychiatry 115:749–764

    Google Scholar 

  30. Whitlock FA, Siskind MM (1980) Depression as a major symptom of multiple sclerosis. J Neurol Neurosurg Psychiatry 43:861–865

    Google Scholar 

  31. Young AC, Saunders J, Ponsford JR (1976) Mental change as an early feature of multiple sclerosis. J Neurol Neurosurg Psychiatry 39:1008–1013

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurologische Klinik, Georg-August-Universität, Robert-Koch-Strasse 40, D-3400, Göttingen, Federal Republic of Germany

    K. Felgenhauer

Authors
  1. K. Felgenhauer
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Dedicated to Professor W. Creutzfeldt on the occasion of his 65th birthday

Rights and permissions

Reprints and permissions

About this article

Cite this article

Felgenhauer, K. Psychiatric disorders in the encephalitic form of multiple sclerosis. J Neurol 237, 11–18 (1990). https://doi.org/10.1007/BF00319661

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00319661

Key words

Search

Navigation