Multiple sclerosis masquerade.

Introduction THIS case report aims to inform general practitioners (GPs) about the psychiatric symptoms that multiple sclerosis (MS) can present with, its co-morbidity with other syndromes, and those psychiatric syndromes that can masquerade as MS. MS is a major cause of neurological disability among the middle-aged and is an important condition cared for in general practice. Among the physical symptoms seen are fatigue, focal neurological deficits and both sexual and sphincter dysfunction. It is also recognised that psychiatric symptoms play a role in the disease course. These may be owing to the direct effects of demyelination, the emotional reaction to this illness, a poor adjustment to chronic illness or the use of steroids. Transient mood changes, such as anxiety and irritability, are experienced by two-thirds of patients in any year, while major depressive criteria are met in one-third of patients.1 Other mood disturbances less commonly seen are euphoria, mania, and pathological laughing or crying.