title: Isolated progressive cognitive impairment and depression in a patient with neuroradiological features suggestive of multiple sclerosis.
abstract: We report the case of a woman who started complaining of depression, attention and memory problems at the age of 49. Over the following 6 years, serial neuropsychological assessments showed fluctuating, but overall progressively worsening, performances in tests exploring attention, working memory, language and executive functions. Cerebrospinal fluid (CSF) examination showed identical IgG oligoclonal bands in serum and CSF. Neurological examination, to date, only reveals minimal pyramidal and cerebellar signs. Although typical clinical and laboratory evidence indicating a diagnosis of multiple sclerosis (MS) in this patient is lacking, an extensive diagnostic work-up ruled out many other causes of leukoencephalopathy and neuroradiological features strongly suggest this diagnosis. Multiple sclerosis may present with cognitive or neuropsychiatric symptoms; this should be kept in mind, especially in younger patients, even in the absence of "classical" physical symptoms.
authors.affiliation: Department of Neurosciences, University of Modena and Reggio Emilia, Baggiovara, Italy. perdiana@tin.it
authors.forename: Diana
authors.initials: D
authors.lastname: Ferraro
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Simone
authors.forename: Elisa
authors.initials: E
authors.lastname: Merelli
authors.forename: Jessica
authors.initials: J
authors.lastname: Mandrioli
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Molinari
authors.forename: Paolo Frigio
authors.initials: PF
authors.lastname: Nichelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Sola
mesh_terms: D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid / Q000276:immunology; D056784:Leukoencephalopathies; D008279:Magnetic Resonance Imaging; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology
chemical_list: D007074:Immunoglobulin G