Childhood multiple sclerosis with psychotic manifestations.

Mental symptoms such as disturbances of mood, affect, and intellectual function in multiple sclerosis are well known. Although actual psychotic manifestations are rare, there are several reports in the literature of patients with multiple sclerosis who, in the course of their disease or preceding it, developed psychotic symptoms (Howes, 1927; Arbuse, 1938; Langworthy, Kolb, and Androp, 1941; Teitelbaum, Hall, and Phillips, 1952; Parker, 1956; Bergin, 1957; Cremieux, Alliez, Toga, and Pache, 1959; Bignami, Gherardi, and Gallo, 1961; Ivers and Goldstein, 1963; M'ur, Kumpel, and Dostal, 1966). Secondly, multiple sclerosis is uncommon in children, although there are several reports of childhood multiple sclerosis in the literature (Low and Carter, 1956; Isler, 1961; Kennedy and Carter 1961; Kuroiwa, Inoue, Araki, and Inoue, 1962; Paine, Goodman, Houck, and Javedan, 1963). Muller (1949) found in his series of 810 patients three (0 37 %) whose illness began between the ages of 5 and 9 years; Gall, Hayles, Siekert, and Keith (1958) found an incidence of 0-4%. We report here a case of multiple sclerosis in an 11-year-old girl who showed unusual mental symptoms. The pathoanatomical lesions are presented and interpreted in the light of the clinical symptoms, especially in respect to the mental changes.