Abstract Details

Title Multiple Sclerosis Presenting with Cognitive Relapse

Topic MS and Related Diseases

Presentation(s) P04 - (-)

Poster/Presentation
Number 113

Objective

Background BACKGROUND: The relapses of MS relasing-remmitting are associated to acute impairment of some neurologic function. The symptoms are variable, but weakness, visual blurring, diplopia, ataxia and sensory disturbances are common described. Cognitive deficit is reported with the accumulation of the SNC lesions, but is not report in the acute relapse. We think that is important to recognize this type of relapse that could be underdiagnosed.

Design/Methods DESIGN/METHODS: We selected three patients with MS that were diagnosed according to the McDonalds's modified criteria (2010), presented with acute changes in different areas of cognition, lasting more than 24 hours, and complete resolution in some days. They were submitted to complete history, physical examination and imaging.

Results RESULTS: Patient 1: Man, 48y, reported acute memory loss 2 years ago, associated to disorientation with remission after one month. Six months ago he presented with similar relapse lasting one week, also with complete resolution after corticosteroid pulsotherapy. MRI showed hyperintense lesion on FLAIR in the temporal region. Patient 2: Female, 36y, MS diagnosed at 32, with acute onset history of anomia and decreased verbal fluency, with normal repetition and interpretation. MRI showed new juxtacortical lesion at left frontal lobe, near the operculum, and previous detected periventricular and pontine lesions. Patient 3: Female, with history of memory loss and temporo-spatial disorientation lasting 2 weeks. She reported dysnomia and dyscalculia with impaired working memory 2 months ago. MRI compatible with MS.

Conclusions CONCLUSIONS: It is increasingly recognized progressive cognitive deterioration in patients with relapsing-remitting MS. However, reports of relapses with purely cognitive impairment are still uncommon. With this evidence, it is essential a careful assessment of the clinical manifestations in MS for proper management.

Authors/Disclosures
Andre P. Matta, MD (Eisai) PRESENTER	Dr. Matta has received personal compensation for serving as an employee of Sanofi. Dr. Matta has received stock or an ownership interest from Sanofi.
	No disclosure on file
	No disclosure on file
Osvaldo J. Nascimento, MD, PhD, FAAN (Fluminense Federal University)	Dr. Nascimento has nothing to disclose.
	No disclosure on file
Eduardo B. Uchoa Cavalcanti, MD, PhD, MSc, FAAN (Hospital Sarah - Lago Norte - Brasília)	Dr. Uchoa Cavalcanti has nothing to disclose.
	No disclosure on file
	No disclosure on file

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