PSYCHOTIC ILLNESS IN PATIENTS WITH ENCEPHALITIS OF UNKNOWN ETIOLOGY - ATYPICAL PRESENTATION OF MULTIPLE-SCLEROSIS

We report on 6 patients (4 female, 2 male, age 17-40 yrs.), admitted to hospital because of psychotic illness. In 2 patients paranoid-hallucinatory symptomatology was prominent, while a manic, a schizo-affective, a catatonic and a mixed organic brain syndrome were found in one case each. Neurological signs could be detected in 4 and EEG-abnormalities in 5 patients. On the basis of CSF findings typical of chronic encephalitis, together with evidence of demyelinating lesions on MRT we confirmed the presence of inflammatory brain disease in all six patients. As a specific etiology could not be established in any of the cases, we suggest the encephalitic variant of multiple sclerosis as the probable diagnosis. In view of our clinical observations, we assume that by using modern investigational techniques - especially sophisticated CSF analysis and MRT - an encephalitic etiology of schizophrenic and affective syndromes may be proven in higher frequency than in the past.