Periodic Lateralized Epileptiform Discharges (PLEDs) in Patients With Neurosyphilis and HIV Infection

Area of Science:

• Neurology
• Neurophysiology
• Infectious Diseases

Background:

• Periodic lateralized epileptiform discharges (PLEDs) are EEG findings associated with various acute brain abnormalities like stroke, encephalitis, and tumors.
• While commonly linked to specific neurological conditions, PLEDs have been rarely reported in neurosyphilis.

Observation:

• Two patients presented with encephalopathy and seizures accompanied by PLEDs.
• Brain MRI revealed abnormalities, with PLEDs appearing ipsilateral or contralateral to these lesions.

Findings:

• Neurosyphilis was diagnosed in both patients through further investigation.
• One patient also had a co-infection with human immunodeficiency virus (HIV).

Implications:

• These findings suggest neurosyphilis should be considered in the differential diagnosis for patients exhibiting PLEDs.
• The increasing incidence of neurosyphilis, particularly with HIV co-infection, highlights the importance of this consideration.