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Teaching NeuroImages: a neurosyphilis case presenting with atypical neuroradiologic findings

Nergiz Agayeva1, Kader Karli-Oguz, Esen Saka

  • 1Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Neurology
|March 13, 2013
PubMed

Insights

Neurosyphilis can cause severe cognitive and neurological symptoms. Prompt penicillin treatment led to significant recovery in a patient with advanced neurosyphilis, highlighting the importance of early diagnosis and intervention.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimaging

Background:

  • Neurosyphilis is a re-emergent infection caused by Treponema pallidum, potentially leading to severe neurological and psychiatric manifestations.
  • Early diagnosis and treatment are crucial for managing neurosyphilis and preventing irreversible neurological damage.

Observation:

  • A 51-year-old male presented with a 4-month history of memory loss, behavioral changes, and seizures.
  • Magnetic Resonance Imaging (MRI) revealed cortical and thalamic hyperintensities with restricted diffusion, indicative of active disease.
  • Positive serum and cerebrospinal fluid (CSF) treponemal antibody tests confirmed the diagnosis of neurosyphilis.

Findings:

  • The patient received penicillin treatment for neurosyphilis.
  • Following treatment, significant improvements in cognitive function (MMSE score increased from 11 to 20) and behavior were observed after six months.

Implications:

  • This case underscores the critical role of neuroimaging and serological tests in diagnosing neurosyphilis.
  • Effective penicillin therapy can lead to substantial neurological and cognitive recovery, emphasizing the importance of timely intervention in neurosyphilis cases.

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