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Related Concept Videos

Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Cranial and Spinal Meninges01:19

Cranial and Spinal Meninges

The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Myasthenia Gravis: Diagnostic Tests01:15

Myasthenia Gravis: Diagnostic Tests

Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
Bacterial Meningitis01:24

Bacterial Meningitis

Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Related Experiment Video

Updated: Jun 3, 2026

Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis
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Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis

Published on: February 23, 2024

Spinal H-Sign in Syphilitic Myelitis Mimicking MOGAD.

Alexandra Akrivaki1, Stefanos Karamanidis1, Evangelia-Makrina Dimitriadou1

  • 1Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

The Neurologist
|June 1, 2026
PubMed
Summary
This summary is machine-generated.

Neurosyphilis can mimic autoimmune myelitis like MOGAD, presenting with the H-sign and flip-flop enhancement. Early diagnosis and treatment of this rare cause of longitudinally extensive transverse myelitis (LETM) are crucial.

Keywords:
H-signMyelin oligodendrocyte glycoprotein antibody diseaseneurosyphilissyphilitic myelitis

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Myelin Oligodendrocyte Glycoprotein (MOG35-55) Induced Experimental Autoimmune Encephalomyelitis (EAE) in C57BL/6 Mice
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Myelin Oligodendrocyte Glycoprotein (MOG35-55) Induced Experimental Autoimmune Encephalomyelitis (EAE) in C57BL/6 Mice

Published on: April 15, 2014

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Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis
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Published on: February 23, 2024

Myelin Oligodendrocyte Glycoprotein (MOG35-55) Induced Experimental Autoimmune Encephalomyelitis (EAE) in C57BL/6 Mice
08:03

Myelin Oligodendrocyte Glycoprotein (MOG35-55) Induced Experimental Autoimmune Encephalomyelitis (EAE) in C57BL/6 Mice

Published on: April 15, 2014

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Longitudinally extensive transverse myelitis (LETM) is often linked to aquaporin-4 antibody-mediated disorders and MOGAD.
  • The "H-sign" on MRI suggests MOGAD, but infectious causes like neurosyphilis can present similarly.
  • Differentiating autoimmune and infectious myelitis is critical for appropriate treatment.

Purpose of the Study:

  • To highlight neurosyphilis as a rare mimic of autoimmune demyelinating myelitis.
  • To emphasize the importance of excluding infectious etiologies in LETM.
  • To report a case of neurosyphilis presenting with characteristic MRI findings of autoimmune myelitis.

Main Methods:

  • Case report of a 50-year-old male with progressive neurological deficits.
  • Thoracic spine MRI showing LETM with "H-sign" and "flip-flop sign."
  • Diagnostic workup including serum and cerebrospinal fluid analysis for syphilis, MOG-IgG, and AQP4-IgG.

Main Results:

  • Neurosyphilis confirmed by reactive serology and CSF findings.
  • Negative MOG-IgG and AQP4-IgG assays.
  • Patient showed significant clinical and radiological improvement after benzylpenicillin and corticosteroid treatment.

Conclusions:

  • Neurosyphilis can mimic antibody-mediated demyelinating disorders like MOGAD.
  • The "H-sign" and "flip-flop sign" can be present in both infectious and autoimmune myelitis.
  • Exclusion of neurosyphilis is essential for accurate diagnosis and management of LETM.