Summary
A 37-year-old man presented with an acute amnestic syndrome of Korsakoff's type and an upper brain-stem oculomotor syndrome. After a moderate improvement with steroid therapy, he developed progressive behavioural changes due to a frontal lobe syndrome, in addition to motor and visual impairment. Memory performance was investigated on several occasions during an 11-year follow-up. Diagnosis of laboratory-supported definite multiple sclerosis was established and magnetic resonance imaging showed disseminated white matter lesions, especially in both medial temporal lobes. No other cause than multiple sclerosis was found for the amnestic syndrome. Among the rare cases of Korsakoff's syndrome in the course of multiple sclerosis, this is to our knowledge the first case in which a memory deficit was the initial manifestation of the disease.
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Beatty WW, Goodkin DE, Monson N, Beatty PA, Hertsgaard D (1988) Anterograde and retrograde amnesia in patients with chronic progressive multiple sclerosis. Arch Neurol 45:611–619
Beatty WW, Goodkin DE, Monson N, Beatty PA (1989) Cognitive disturbances in patients with relapsing remitting multiple sclerosis. Arch Neurol 46:1113–1119
Beatty WW, Goodkin DE, Beatty PA, Monson N (1989) Frontal lobe dysfunction and memory impairment in patients with chronic progressive multiple slerosis. Brain Cogn 11:73–86
Bergin JD (1957) Rapidly progressing dementia in disseminated sclerosis. J Neurol Neurosurg Psychiatry 20:285–292
Brainin M, Goldberg G, Ahlers C, Reisner T, Neuhold A, Deecke L (1988) Structural brain correlates of anterograde memory deficits in multiple sclerosis. J Neurol 235:362–365
Caine ED, Bamford KA, Schiffer RB, Shoulson I, Levy S (1986) A controlled neuropsychological comparison of Huntington's disease and multiple sclerosis. Arch Neurol 43:249–254
Callanan MM, Logsdail SJ, Ron MA, Warrington EK (1989) Cognitive impairment in patients with clinically isolated lesions of the type seen in multiple sclerosis. Brain 112:361–374
Carroll M, Gates R, Roldan F (1984) Memory impairment in multiple sclerosis. Neuropsychologia 22:297–302
Charcot JM (1872) Leçon sur les maladies du système nerveux. Delahaye Paris
Feinstein A, Ron M (1989) Korsakoff's psychosis in the presence of multiple sclerosis: an unusual cognitive state. J Neurol Neurosurg Psychiatry 52:540–541
Franklin GM, Heaton RK, Nelson LM, Filley CM, Seibert C (1988) Correlation of neuropsychological and MRI findings in chronic/progressive multiple slerosis. Neurology 38:1826–1829
Franklin GM, Nelson LM, Filley CM, Heaton RK (1989) Cognitive loss in multiple sclerosis. Arch Neurol 46:162–167
Gherardi R, Salama J, Gray F, Kemeny JL, Delaporte P, Poirier J, Cambier J (1985) Lymphome cérébral associé à des lésions de sclérose en plaques. Rev Neurol (Paris) 141:456–463
Grant I, McDonald WI, Trimble MR, Smith E, Reed R (1984) Deficient learning and memory in early and middle phases of multiple sclerosis. J Neurol Neurosurg Psychiatry 47:250–255
Huber SJ, Paulson GW, Shuttleworth EC, Chakeres D, Clapp LE, Pakalnis A, Wess K, Rammohan K (1987) Magnetic resonance imaging correlates of dementia in multiple sclerosis. Arch Neurol 44:732–736
Jennekens-Schindel A, Sanders EACM (1986) Decline of cognition in multiple sclerosis: dissociable deficits. J Neurol Neurosurg Psychiatry 49:1354–1360
Kamalian N, Keesey RE, ZuRhein GM (1975) Lateral hypothalamic demyelination and cachexia in a case of “malignant” multiple sclerosis. Neurology 25:25–30
Koenig H (1968) Dementia associated with the benign form of multiple sclerosis. Trans Am Neurol Assoc 93:227–228
Lanares J, Assal G, Regli F (1984) Etude neuropsychologique clinique d'une population de patients atteints de sclérose en plaques. Schweiz Med Wochenschr 114:141–144
Lhermitte F, Signoret JL (1972) Analyse neuropsychologique et différentiation des syndromes amnésiques. Rev Neurol (Paris) 126:161–178
Litvan I, Grafman J, Vendrell P, Martinez JM (1988) Slowed information processing in multiple sclerosis. Arch Neurol 45:281–285
Litvan I, Grafman J, Vendrell P, Martinez JM, Junque C, Vendrell JM, Barraquer-Bordas JL (1988) Multiple memory deficits in patients with multiple sclerosis. Arch Neurol 45:607–610
Lyon-Caen O, Jouvent R, Hauser S, Chaunu MP, Benoit N, Wildöcher D, Lhermitte F (1986) Cognitive function in recent-onset demyelinating diseases. Arch Neurol 43:1138–1141
Peyser JM, Edwards KR, Poser CM, Filskov SB (1980) Cognitive function in patients with multiple sclerosis. Arch Neurol 53:577–579
Poser CM, Paty DW, Schernberg L, McDonald WJ, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis-guidelines for research protocols. Ann Neurol 13:227–231
Rao SM, Hammeke TA, McQuillen MP, Khatri BO, Lloyd D (1984) Memory disturbance in chronic progressive multiple sclerosis. Arch Neurol 41:625–631
Rao SM, Glatt S, Hammeke TA, McQuillen MP, Khatri BO, Rhodes AM, Pollard S (1985) Chronic progressive multiple sclerosis. Arch Neurol 42:678–682
Rao SM, Leo GJ, Haughton VM, St Aubin-Faubert P, Bernardin L (1989) Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis. Neurology 39:161–166
Signoret JL, Whiteley A (1979) Memory battery scale. Int Neuropsychol Soc Bull 9:2–26
Staples D, Lincoln NB (1979) Intellectual impairment in multiple sclerosis and its relation to functional abilities. Rheumatol Rehabil 18:152–160
Trillet M, Girard PF, Beyvin AJ (1972) Syndrome de Korsakoff post comitial au cours de l'évolution d'une sclérose multiloculaire. J Med Lyon 53:539–547
Ule G (1958) Pathologische-anatomische Befunde bei Korsakowpsychosen und ihre Bedeutung für die Localisationslehre in der Psychiatrie. Ärztl Wochenschr 13:6–13
Van Den Burg W, Zomeren AH van, Minderhoud JM, Prange AJA, Meijer NSA (1987) Cognitive impairment in patients with multiple sclerosis and mild physical disability. Arch Neurol 44:494–501
Young AC, Saunders J, Ponsford JR (1976) Mental changes as an early feature in multiple sclerosis. J Neurol Neurosurg Psychiatry 39:1008–1013
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Vighetto, A., Charles, N., Salzmann, M. et al. Korsakoff's syndrome as the initial presentation of multiple sclerosis. J Neurol 238, 351–354 (1991). https://doi.org/10.1007/BF00315338
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DOI: https://doi.org/10.1007/BF00315338