title: Acute severe memory impairment as a presenting symptom of multiple sclerosis: a clinical case study with 3D double inversion recovery MR imaging.
abstract: We present the case of a 21-year-old woman with acute memory impairment. It was initially not recognized as organic in nature. Repeated neuropsychological testing confirmed severely disturbed encoding and recall. Three-dimensional double inversion recovery (3D-DIR) MRI confirmed hippocampal and cortical lesions. Further clinical symptoms, visual evoked potential and MRI suggested a diagnosis of multiple sclerosis (MS). The amnestic syndrome has remained for 5 years. This case illustrates that MS can present with acute cortical symptoms which can be difficult to recognize. The hippocampus can be acutely affected and DIR MRI imaging can help to demonstrate cortical lesions that explain the clinical picture.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Haga Teaching Hospital, The Hague, The Netherlands. coebergh@doctors.org.uk
authors.forename: J A F
authors.initials: JA
authors.lastname: Coebergh
authors.forename: S D
authors.initials: SD
authors.lastname: Roosendaal
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
authors.forename: J J
authors.initials: JJ
authors.lastname: Geurts
authors.forename: T C A M
authors.initials: TC
authors.lastname: van Woerkom
mesh_terms: D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008569:Memory Disorders / Q000209:etiology* / Q000473:pathology; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology*; D009483:Neuropsychological Tests; D055815:Young Adult