title: Severe impulsiveness as the primary manifestation of multiple sclerosis in a young female.
abstract: Severe impulsiveness in the absence of apparent neurological signs has rarely been reported as a clinical presentation of multiple sclerosis (MS). An 11-year-old female developed progressive and sustained personality disturbances including disinhibition, hypersexuality, drug abuse, aggressiveness and suicide attempts, without neurological signs. She was given several unsuccessful psychopharmacological and psychotherapeutic interventions. At age 21, a diagnosis of MS was made, confirmed by imaging, laboratory and neurophysiological studies. Although unusual, MS may produce pure neurobehavioral disturbances. In the present case, widespread demyelinization produced a complex behavioral disorder, with features compatible with orbitofrontal and Klüver-Bucy syndromes.
authors.affiliation: Department of Neurology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
authors.forename: Elmer
authors.initials: E
authors.lastname: Lopez-Meza
authors.forename: Teresa
authors.initials: T
authors.lastname: Corona-Vazquez
authors.forename: Luis A
authors.initials: LA
authors.lastname: Ruano-Calderon
authors.forename: Jesus
authors.initials: J
authors.lastname: Ramirez-Bermudez
mesh_terms: D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002648:Child; D003024:Clozapine / Q000627:therapeutic use; D005260:Female; D006708:Homicide / Q000523:psychology; D006801:Humans; D007175:Impulsive Behavior / Q000188:drug therapy / Q000209:etiology / Q000523:psychology*; D008279:Magnetic Resonance Imaging; D008418:Masturbation; D009103:Multiple Sclerosis / Q000473:pathology / Q000523:psychology*; D010551:Personality; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011477:Sex Work; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000523:psychology; D013405:Suicide / Q000523:psychology; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs; D014635:Valproic Acid; D003024:Clozapine