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Panic disorder as presenting symptoms of multiple sclerosis

Background

Multiple sclerosis (MS) is a chronic demyelinating disorder characterized by multiple neuropsychiatric symptoms Psychiatric disorders and symptoms may accompany the course of MS as primary or secondary reasons [1, 2]. We will present a case report with panic disorder as presenting symptoms of multiple sclerosis.

Materials and methods

A 47 years old female patient admitted to psychiatry clinic with attacs of palpitation, sweating, dispnea with a feeling of heart attack. These symptoms were present for 3 months,3-4 times a week and the patient started to have expectation anxiety. She was diagnosed as panic disorder and started paroxetine 20 mg/day. After one month her symptoms were not beter, and because of reference delusions as if people were looking at her, olanzapine 10 mg/day was added. After another month of medication, because she was not better, she was sent to neurology and she had a cerebral magnetic resonance imaging(MRI).In her neurologic examination her deep tendon reflexes were found to be increased. In her MRI a right frontal 10 × 5 mm periventricular deep white matter plaque and multiple subcorticle white matter hyperintense plaques were seen. In her serebrospinal oligoclonal band was positive. She was diagnosed as multiple sclerosis and after 5 day treatment of methylprednisolone 1000 mg/day, her psychiatric symptoms disappeared.

Results

Psychiatric symptoms may be primary symptoms of a new demyelinization epizode.

Conclusions

A MS patient may admit with psychiatric symptoms and there may be a misdiagnosis of psychiatric disorder.

References

  1. 1.

    Korostil M, Feinstein A: Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler. 2007, 13 (1): 67-72. 10.1177/1352458506071161.

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    Minden SL: Mood disorders in multiple sclerosis: diagnosis and treatment. J Neurovirol. 2000, 6 (Suppl 2): S160-7.

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Correspondence to Demet İlhan Algin.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Algin, D.İ., Kilicoglu, A. & Koplay, M. Panic disorder as presenting symptoms of multiple sclerosis. Ann Gen Psychiatry 9, S138 (2010). https://doi.org/10.1186/1744-859X-9-S1-S138

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Keywords

  • Multiple Sclerosis
  • White Matter
  • Olanzapine
  • Multiple Sclerosis Patient
  • Paroxetine