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Neurosyphilis in disguise.

Ammar Jum'ah1, Hassan Aboul Nour2, Mohammad Alkhoujah2

  • 1Department of Neurology, Henry Ford Hospital, 1350 W. Bethune St, Detroit, MI, 48202, USA. ajumah1@hfhs.org.

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Summary

Neurosyphilis, a mimic of other diseases, presents diverse MRI findings. Anterior temporal lobe enhancement is a rare sign that requires careful neurosyphilis evaluation to ensure timely diagnosis and treatment.

Keywords:
Anterior Temporal LobeMRIMesisal Temporal LobeNeurosyphilisSyphilis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Neurosyphilis, caused by Treponema pallidum, is a complex infection mimicking various neurological conditions.
  • Accurate diagnosis of neurosyphilis is crucial for effective patient management and treatment strategies.

Observation:

  • A case of a 69-year-old female with neurosyphilis presented with atypical anterior temporal lobe enhancement on MRI.
  • This imaging finding mimicked herpes simplex virus (HSV) encephalitis, highlighting the diagnostic challenges.

Findings:

  • Neurosyphilis exhibits a wide spectrum of imaging patterns on MRI, varying in early and late stages.
  • Anterior temporal lobe involvement is an uncommon but significant radiological presentation of neurosyphilis.

Implications:

  • Clinicians must recognize the diverse radiological manifestations of neurosyphilis to avoid misdiagnosis.
  • Awareness of rare presentations like anterior temporal lobe enhancement is vital for prompt neurosyphilis diagnosis and intervention.