Diversity in clinical manifestations and imaging features of neurosyphilis: obstacles to the diagnosis and treatment (report of three cases)

Int J Neurosci. 2018 Aug;128(8):785-790. doi: 10.1080/00207454.2017.1412963. Epub 2017 Dec 17.

Abstract

Objective: To explore the clinical manifestations and imaging features of neurosyphilis and to discuss the obstacles in the diagnosis and treatment of neurosyphilis.

Methods: We present this case study involving three cases of definite neurosyphilis, focusing on their clinical data.

Results: Case 1 is a patient with numb and weak left lower limb. Case 2 showed slow reaction and dementia behaviors including worse memory and the decrease of calculation and orientation ability in this patient. Case 3 is a peripheral incomplete left oculomotor nerve palsy patient. Magnetic resonance imaging findings of three patients are different. And single photon emission computed tomography showed the regional cerebral blood flow was all hypoperfused. There were some difficulties in diagnosing and treating the patients in these three cases.

Conclusion: The clinical manifestations and imaging findings of neurosyphilis are diverse. Clinicians should pay attention to neurosyphilis. After clear diagnosis, patients would receive norm treatment in time.

Keywords: Neurosyphilis; clinical manifestations; diagnosis; treatment.

Publication types

  • Case Reports

MeSH terms

  • Agglutination Tests
  • Antibodies, Bacterial / metabolism
  • Cerebrovascular Circulation
  • Cysteine / analogs & derivatives
  • Cysteine / pharmacokinetics
  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Neurosyphilis / diagnosis*
  • Neurosyphilis / microbiology
  • Neurosyphilis / physiopathology
  • Neurosyphilis / therapy*
  • Organotechnetium Compounds / pharmacokinetics
  • Tomography, Emission-Computed, Single-Photon*
  • Treponema pallidum / immunology
  • Treponema pallidum / pathogenicity

Substances

  • Antibodies, Bacterial
  • Organotechnetium Compounds
  • technetium Tc 99m bicisate
  • Cysteine