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Syphilitic myelitis with diffuse spinal cord abnormality on MR imaging.
1Department of Radiology, Tuen Mun Hospital, Tuen Mun, Hong Kong. eyktsui@hotmail.com
European Radiology
|November 20, 2002
Summary
Syphilitic myelitis, a rare neurosyphilis complication, presents unique MRI findings of diffuse spinal cord changes. Despite treatment, significant neurological deficits often persist in patients with this rare condition.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Syphilitic myelitis is an uncommon manifestation of neurosyphilis.
- The characteristic magnetic resonance imaging (MRI) findings of syphilitic myelitis are not well-established, with limited case reports available.
- Neurosyphilis requires timely diagnosis and treatment to prevent irreversible neurological damage.
Observation:
- A 52-year-old woman presented with acute paraplegia.
- Spinal MRI revealed diffuse T2-weighted hyperintensity throughout the entire spinal cord.
- T1-weighted gadolinium-enhanced MRI demonstrated focal enhancement in the thoracic dorsal cord.
Findings:
- The observed diffuse spinal cord abnormality in syphilitic myelitis is novel and has not been previously reported in international literature.
- Post-antibiotic therapy, MRI showed resolution of diffuse high-signal lesions but persistent focal enhancement.
- Despite imaging improvements, the patient experienced substantial and lasting neurological deficits.
Implications:
- This case highlights the importance of considering neurosyphilis in the differential diagnosis of myelitis, even with atypical MRI findings.
- The discrepancy between imaging improvement and persistent neurological deficits underscores the severity and potential long-term impact of syphilitic myelitis.
- Further research and case reporting are crucial for better understanding and managing this rare neurological condition.