Possible Contribution of Multiple Sclerosis Pathology to Treatment-Resistant Schizophrenia: A Case Study.
Sho Miura, Atsuko Nagaoka, Mizuki Hino et al.
✦ AI-curated · Sources linked
Case in brief
A woman in her 50s presented with persecutory delusions and a sense of being surveilled, initially diagnosed with schizophrenia. Despite long-term antipsychotic treatment, her symptoms worsened. Subsequent MRI revealed multiple white matter lesions, and cerebrospinal fluid analysis showed oligoclonal bands, leading to a diagnosis of multiple sclerosis. Treatment with ofatumumab and clozapine resulted in partial symptom improvement.
What made this case unusual
The case illustrates the diagnostic challenge of distinguishing between schizophrenia and multiple sclerosis, particularly when both conditions present with overlapping psychiatric symptoms.
Diagnostic / clinical pearl
Clinicians should consider the possibility of comorbid multiple sclerosis in patients with treatment-resistant schizophrenia, especially when atypical neurological features are present.
Why it matters
This case underscores the importance of recognizing potential underlying neurological conditions that may contribute to psychiatric symptoms, which can influence treatment strategies.