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<p>Amyotrophic lateral sclerosis (ALS) is a&#xa0;progressive, lethal, multisystemic neurodegenerative disorder characterized by combined degeneration of the upper- (UMN) and lower motor neurons (LMN). Diagnosis is based on the “Gold Coast Citeria,” which require progressive motor impairment, evidence for UMN and LMN damage in at least one body region, and the absence of any alternative explanation. Pathognomonic for ALS is the coexistence of both atrophic–flaccid and spastic paresis. In addition to the motor changes, affective and psychotic symptoms may occur.</p><p>This case report highlights how early psychotic symptoms can mask an underlying motor neuron disease and illustrates the importance of considering ALS in patients presenting with atypical or treatment-resistant psychotic symptoms combined with progressive speech difficulties or motor impairment. Close collaboration between psychiatry and neurology, timely genetic testing, and interdisciplinary management are essential to avoid diagnostic delays and ensure optimal patient care.</p>

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Psychotische Symptome als frühe Manifestation der amyotrophen Lateralsklerose: Ein Fallbericht zum ALS-FTD Spektrum

  • 期刊论文

  • 发表日期：

    2026年1月21日

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  • Lukas Lühr,
  • Romana Wimmer

摘要

Amyotrophic lateral sclerosis (ALS) is a progressive, lethal, multisystemic neurodegenerative disorder characterized by combined degeneration of the upper- (UMN) and lower motor neurons (LMN). Diagnosis is based on the “Gold Coast Citeria,” which require progressive motor impairment, evidence for UMN and LMN damage in at least one body region, and the absence of any alternative explanation. Pathognomonic for ALS is the coexistence of both atrophic–flaccid and spastic paresis. In addition to the motor changes, affective and psychotic symptoms may occur.

This case report highlights how early psychotic symptoms can mask an underlying motor neuron disease and illustrates the importance of considering ALS in patients presenting with atypical or treatment-resistant psychotic symptoms combined with progressive speech difficulties or motor impairment. Close collaboration between psychiatry and neurology, timely genetic testing, and interdisciplinary management are essential to avoid diagnostic delays and ensure optimal patient care.