B - 104 Late-Onset Multiple Sclerosis: a Neuropsychological Case Study.

Abstract

A neuropsychological case study of Late-Onset Multiple Sclerosis (LOMS). Cognitive impairment often accompanies Multiple Sclerosis (MS). Depending on disease phase/type, 40-65% of MS patients develop various degrees of cognitive impairment. LOMS is a rare branch of Multiple Sclerosis with an onset of 50years or older. Like MS it has demyelinating qualities, however it typically has a neurodegenerative course rather than inflammatory properties. Additionally, unlike traditional MS, LOMS presents with greater motor and cognitive dysfunction. The patient, a 61-year-old, Caucasian, right-handed male, 18years of education initially presented with acute onset of vague cognitive changes along with significant motor dysfunction. A cerebral MRI revealed white matter disease in the cerebral hemispheres with the largest lesion adjacent to the right frontal horn. Lesions involved bifrontal/parietal lobes, specific lesion posteriorly in the left centrum and right caudate head. Patient was administered the Meyers Neuropsychological Battery (MNB). Findings were consistent with level one central processing deficits with attention/concentration and processing speed. Deficits were noted with primary and psychomotor abilities. Patient's premorbid estimate was T-58. Overall Test Battery Mean (T-52) and Domain Test Battery Mean (T-51) were generally within the expected range. Remaining neuropsychological abilities were relatively intact (e.g., memory, abstraction, language, spatial). Consistent with the literature, higher-order cognitive abilities were relatively intact. LOMS mirrored early-onset MS in this case. However, a significant risk factor for LOMS is the possibility of co-occurring neurodegenerative disease. This underscores the need for comprehensive neuropsychological assessment that includes motor testing for MS.