Neurosyphilis Presenting with Isolated Abducens Nerve Palsy

Area of Science:

• Neurology
• Infectious Diseases
• Ophthalmology

Background:

• Neurosyphilis is a complex infection affecting the nervous system.
• Abducens nerve palsy typically presents with double vision (diplopia).
• Isolated abducens nerve palsy is an uncommon neurological manifestation.

Purpose of the Study:

• To report a rare case of neurosyphilis presenting solely with bilateral abducens nerve palsy.
• To highlight neurosyphilis as a potential differential diagnosis for isolated abducens nerve palsy.
• To emphasize the utility of advanced imaging in diagnosing neurosyphilis.

Main Methods:

• Case report of a 39-year-old male patient with diplopia.
• Neurological examination revealing bilateral abducens nerve palsy.
• Laboratory tests including serum and cerebrospinal fluid syphilis assays.
• Magnetic resonance imaging (MRI) with contrast enhancement.

Main Results:

• The patient presented with isolated bilateral abducens nerve palsy.
• Syphilis tests were positive in both serum and cerebrospinal fluid.
• Contrast-enhanced MRI showed abnormalities on the abducens nerve.
• Diagnosis of active neurosyphilis was confirmed.

Conclusions:

• Neurosyphilis should be considered in the differential diagnosis of isolated abducens nerve palsy, even if rare.
• Contrast-enhanced MRI is a valuable tool for diagnosing neurosyphilis presenting with cranial nerve palsies.
• Prompt diagnosis and treatment are essential for managing neurosyphilis.