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Submitted: 26 February 2013 Modified: 01 March 2013
HERDIN Record #: R04A-DLSHSI-13022611111510

" The Life that Stood" . A case report of Neurosyphillis that manifests with seizure, acute cerebral infarction, dementia and psychosis.

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Background: Neurosyphilis results from infection of the brain, meninges or spinal cord by Treponema pallidum and develop in up to 10 percent of patients with untreated syphilis. Neurosyphilis should be considered in patients with signs or symptoms of neurologic involvement at any stage of infection and in all patients with late latent or tertiary syphilis, although asymptomatic neurosyphilis is the most common presentation. Syphilis remains a disease of modern-day society despite the decrease of the case numbers in the latest years. Based on the illness history, clinical and neurological examination, laboratory studies and neuroimaging, the diagnosis of neurosyphilis was determined. This article reports a case of active neurosyphilis with seizure, acute cerebral infarction, dementia and psychosis. During the treatment with Penicillin, Jarisch-Herxheimer reaction was observed.

The clinical feature is characterized by a generalized tonic-clonic seizure hours prior to admission and slow progressive cognitive decline and behavior changes for the last 2 years. Neuropsychological examination revealed dementia with impaired memory, attention and executive function. Acute cerebral infarction on the left frontal lobe and cerebral atrophic changes were documented.

In conclusion, the myriad of signs of symptoms that may manifest with patients with neurosyphilis especially if no primary and secondary lesions have been observed, will delay the diagnosis of neurosyphilis. Seizure, deterioration in cognition and behavioral disturbances should be a part of the differential diagnosis of each patient manifesting the symptoms.

Setting: De La Salle University Medical Center

Objectives

To present a case of neurosyphilis with the manifestation of seizure, acute cerebral infarction, dementia and psychosis.

LocationLocation CodeAvailable FormatAvailability
3/F Room 6301 De La Salle Angelo King Medical Research Center Fulltext Print Format

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