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A patient with neurosyphilis presenting as chorea
1Department of Medicine, Royal Infirmary, Edinburgh.
Scottish Medical Journal
|June 1, 1993
Summary
Neurosyphilis, though declining, still occurs, sometimes presenting atypically. This case highlights neurosyphilis with choreoathetosis and hemiparesis in an immunocompetent patient, a rare basal ganglia manifestation.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosyphilis
Background:
- Neurosyphilis (NS) frequency has declined in the UK over 30 years.
- NS continues to emerge sporadically and with HIV infection.
- Clinical presentation of NS is evolving, becoming less typical.
Observation:
- A case of NS in an immunocompetent patient is presented.
- The patient exhibited predominantly choreoathetosis and hemiparesis.
- This presentation suggests basal ganglia involvement.
Findings:
- Only six cases of NS with basal ganglia damage features are in recent literature.
- Five of these reported cases were in HIV-infected individuals.
- This case represents a rare NS presentation in an immunocompetent host.
Implications:
- Highlights the diverse and evolving clinical spectrum of neurosyphilis.
- Emphasizes the importance of considering NS in patients with unexplained movement disorders.
- Suggests NS may present with basal ganglia signs even in immunocompetent individuals.