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Case report
peer-reviewed

Psychiatric Symptoms as the First Clinical Presentation of Multiple Sclerosis: A Case Report



Abstract

Multiple sclerosis (MS) is an autoimmune condition which affects the axon myelination in the brain. There can be multiple ways it can present initially, but physical signs and symptoms are the most common ones. We are reporting a case of MS from Pakistan which presented with neuropsychiatric features and was offered psychiatric care, but the patient declined treatment because of stigma related to psychiatric care. Four months later when her condition worsened, further investigation showed it to be a case of MS. The purpose of this case report is that psychiatric features should be considered for differentials of MS.



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Case report
peer-reviewed

Psychiatric Symptoms as the First Clinical Presentation of Multiple Sclerosis: A Case Report


Author Information

Muhammad Aadil

Department of Medicine, FMH College of Medicine

Aitzaz Munir

Department of Psychiatry, Howard University Hospital

Muhammad Jahanzaib Anwar

Department of Internal Medicine, Rush University Medical Center

Department of Ophthalmology, Bahawal Victoria Hospital, Bahawalpur, Pakistan

Hasnain Arshad Corresponding Author

Department of Internal Medicine, Howard University Hospital

Ibrar Anjum

Internal medicine, University of health science Lahore

Aniqa Faraz

Department of Internal Medicine, King Edward Medical University Lahore, Pakistan


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Psychiatric Symptoms as the First Clinical Presentation of Multiple Sclerosis: A Case Report


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Case report
peer-reviewed

Psychiatric Symptoms as the First Clinical Presentation of Multiple Sclerosis: A Case Report

  • Author Information
    Muhammad Aadil

    Department of Medicine, FMH College of Medicine

    Aitzaz Munir

    Department of Psychiatry, Howard University Hospital

    Muhammad Jahanzaib Anwar

    Department of Internal Medicine, Rush University Medical Center

    Department of Ophthalmology, Bahawal Victoria Hospital, Bahawalpur, Pakistan

    Hasnain Arshad Corresponding Author

    Department of Internal Medicine, Howard University Hospital

    Ibrar Anjum

    Internal medicine, University of health science Lahore

    Aniqa Faraz

    Department of Internal Medicine, King Edward Medical University Lahore, Pakistan


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: July 15, 2017

    DOI

    10.7759/cureus.1474

    Cite this article as:

    Aadil M, Munir A, Anwar M, et al. (July 15, 2017) Psychiatric Symptoms as the First Clinical Presentation of Multiple Sclerosis: A Case Report. Cureus 9(7): e1474. doi:10.7759/cureus.1474

    Publication history

    Received by Cureus: June 16, 2017
    Peer review began: June 26, 2017
    Peer review concluded: July 05, 2017
    Published: July 15, 2017

    Copyright

    © Copyright 2017
    Aadil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Multiple sclerosis (MS) is an autoimmune condition which affects the axon myelination in the brain. There can be multiple ways it can present initially, but physical signs and symptoms are the most common ones. We are reporting a case of MS from Pakistan which presented with neuropsychiatric features and was offered psychiatric care, but the patient declined treatment because of stigma related to psychiatric care. Four months later when her condition worsened, further investigation showed it to be a case of MS. The purpose of this case report is that psychiatric features should be considered for differentials of MS.



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Create a free account to continue reading this article.

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Muhammad Aadil

Department of Medicine, FMH College of Medicine

Aitzaz Munir, M.D.

Department of Psychiatry, Howard University Hospital

Muhammad Jahanzaib Anwar

Department of Internal Medicine, Rush University Medical Center

Hasnain Arshad

Department of Internal Medicine, Howard University Hospital

For correspondence:
hasnainiqbalian91@gmail.com

Ibrar Anjum

Internal medicine, University of health science Lahore

Aniqa Faraz

Department of Internal Medicine, King Edward Medical University Lahore, Pakistan

Muhammad Aadil

Department of Medicine, FMH College of Medicine

Aitzaz Munir, M.D.

Department of Psychiatry, Howard University Hospital

Muhammad Jahanzaib Anwar

Department of Internal Medicine, Rush University Medical Center

Hasnain Arshad

Department of Internal Medicine, Howard University Hospital

For correspondence:
hasnainiqbalian91@gmail.com

Ibrar Anjum

Internal medicine, University of health science Lahore

Aniqa Faraz

Department of Internal Medicine, King Edward Medical University Lahore, Pakistan