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[MRI features of neurosyphilis]
M Brisset1, M L Chadenat, Y Cordoliani
1Service de neurologie et unité neurovasculaire, centre hospitalier de Versailles, hôpital A.-Mignot, 1, rue Richaud, 78000 Versailles, France.
Revue Neurologique
|March 29, 2011
Summary
Neurosyphilis, a rare condition, can manifest decades after untreated syphilis. This case highlights the importance of syphilis testing for psychiatric disorders and presents unique brain MRI findings in a patient with general paresis and tabes dorsalis.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Context:
- Neurosyphilis is a rare tertiary manifestation of syphilis, typically occurring years after initial infection.
- Delayed diagnosis of neurosyphilis can lead to severe neurological and psychiatric sequelae.
- Brain Magnetic Resonance Imaging (MRI) findings in neurosyphilis are not widely documented.
Purpose:
- To report a rare case of neurosyphilis presenting 25 years after untreated primary syphilis.
- To illustrate the clinical and neuroimaging features of a patient with general paresis and tabes dorsalis.
- To emphasize the diagnostic value of syphilitic serology in patients with subacute psychiatric symptoms.
Summary:
- A 65-year-old male presented with psychiatric disorders, general paresis, frontal syndrome, tabes dorsalis, and Argyll-Robertson pupils, consistent with neurosyphilis.
- Brain MRI revealed bilateral high-intensity signals on T2-weighted sequences in the mesiotemporal, insular, and frontal regions.
- The patient's presentation occurred 25 years after untreated primary syphilis, underscoring the potential for late-onset neurosyphilis.
Impact:
- This case contributes to the limited literature on detailed brain MRI findings in neurosyphilis.
- It reinforces the necessity of considering syphilitic serology in the differential diagnosis of subacute psychiatric and neurological disorders.
- Highlights the importance of recognizing delayed-onset neurosyphilis for timely intervention and management.
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