title: Psychiatric disorders revealing multiple sclerosis after 20 years of evolvement.
abstract: Previous research indicates that the onset of psychiatric disorders is sometimes associated with multiple sclerosis (MS) evolving several years later. However, information on why this might occur, and on the outcomes of such patients, is still lacking. We aim to discuss these limitations with the current paper. We describe a 51-year-old female who demonstrated severe anxiety disorder and depression years before developing MS neurological symptoms. The patient was treated for these psychiatric disorders over 20 years. In the last 3 years of her treatment, the patient demonstrated a choreic-type of movement disorder in all her limbs. This disorder is consistent with relapsing-remitting MS. Clinical and magnetic resonance imaging (MRI) examinations demonstrated aspects of MS, without MS being diagnosed conclusively. The visual evoked potential indicated a diagnosis of conduction abnormalities. The established diagnosis was slow relapsing MS. The patient underwent methylprednisolone bolus (1 g/day). This case-study suggests that health professionals should conduct a full neurological assessment when they find atypical psychiatric symptoms in a patient. This would make sure that patients receive a better standard of care, and thus experience a better quality of life.
authors.affiliation: Department of Neurology, University Hospital of Fez, Fez, Morocco.
authors.forename: Aicha Slassi
authors.initials: AS
authors.lastname: Sennou
authors.affiliation: Department of Biophysics and Clinical MRI Methods, Faculty of Medicine and Pharmacy of Fez, Fez, Morocco ; Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Fez, Morocco.
authors.forename: Saïd
authors.initials: S
authors.lastname: Boujraf
authors.affiliation: Department of Neurology, University Hospital of Fez, Fez, Morocco.
authors.forename: Mohammed Faouzi
authors.initials: MF
authors.lastname: Belahsen
authors.affiliation: Department of Neurology, University Hospital of Fez, Fez, Morocco ; Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Fez, Morocco.
authors.forename: Ouafae
authors.initials: O
authors.lastname: Messouak
keywords: Lengthy and very slow evolvement; multiple sclerosis; psychiatric disorders