Multiple sclerosis presenting with fantastic confabulation

Multiple sclerosis (MS) is the most common inflammatory, demyelinating disease of the central nervous system. Besides neurological signs and symptoms, the disease may be associated with various psychiatric manifestations, and uncommonly, psychiatric manifestations may be the presenting symptom. On the other hand, confabulation is defined as falsification of memory occurring in clear consciousness in association with an organically derived amnesia or as spontaneous narrative reports of events that never happened. We report an unusual association of confabulation with MS. A 23-year-old man was admitted to a hospital, telling unusual stories. After evaluation and a detailed workup, the patient was given the diagnosis of MS with fantastic confabulations. Neuropsychological evaluation revealed mild frontal lobe dysfunction. Confabulation has been reported after frontal lobe lesions and is also hypothesized to be associated with a deficit primarily in the retrieval of more than one of the following: encoding, consolidation or storage. Clinicians' awareness of this kind of rare association may further enlighten the neural basis of confabulation.