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

We report on 6 patients (4 female, 2 male, age 17-40 yrs.), admitted t o hospital because of psychotic illness. In 2 patients paranoid-halluc inatory symptomatology was prominent, while a manic, a schizo-affectiv e, a catatonic and a mixed organic brain syndrome were found in one ca se each. Neurological signs could be detected in 4 and EEG-abnormaliti es in 5 patients. On the basis of CSF findings typical of chronic ence phalitis, together with evidence of demyelinating lesions on MRT we co nfirmed 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 prob able diagnosis. In view of our clinical observations, we assume that b y using modern investigational techniques - especially sophisticated C SF analysis and MRT - an encephalitic etiology of schizophrenic and af fective syndromes may be proven in higher frequency than in the past.