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Logo of agpsychBioMed Centralbiomed central web sitesearchsubmit a manuscriptregisterthis articleAnnals of General Psychiatry
Ann Gen Psychiatry. 2010; 9(Suppl 1): S138.
Published online 2010 April 22. doi:  10.1186/1744-859X-9-S1-S138
PMCID: PMC2991823

Panic disorder as presenting symptoms of multiple sclerosis


Multiple sclerosis (MS) is a chronic demyelinating disorder characterized by multiple neuropsychiatric symptoms Psychiatric disorders and symptoms may accompany the course of MS as primary or secondary reasons [1,2]. We will present a case report with panic disorder as presenting symptoms of multiple sclerosis.

Materials and methods

A 47 years old female patient admitted to psychiatry clinic with attacs of palpitation, sweating, dispnea with a feeling of heart attack. These symptoms were present for 3 months,3-4 times a week and the patient started to have expectation anxiety. She was diagnosed as panic disorder and started paroxetine 20 mg/day. After one month her symptoms were not beter, and because of reference delusions as if people were looking at her, olanzapine 10 mg/day was added. After another month of medication, because she was not better, she was sent to neurology and she had a cerebral magnetic resonance imaging(MRI).In her neurologic examination her deep tendon reflexes were found to be increased. In her MRI a right frontal 10 × 5 mm periventricular deep white matter plaque and multiple subcorticle white matter hyperintense plaques were seen. In her serebrospinal oligoclonal band was positive. She was diagnosed as multiple sclerosis and after 5 day treatment of methylprednisolone 1000 mg/day, her psychiatric symptoms disappeared.


Psychiatric symptoms may be primary symptoms of a new demyelinization epizode.


A MS patient may admit with psychiatric symptoms and there may be a misdiagnosis of psychiatric disorder.


  • Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler. 2007;13(1):67–72. doi: 10.1177/1352458506071161. [PubMed] [Cross Ref]
  • Minden SL. Mood disorders in multiple sclerosis: diagnosis and treatment. J Neurovirol. 2000;6(Suppl 2):S160–7. [PubMed]

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