Neurosyphilis masquerading as oculomotor nerve palsy in a healthy middle-aged man: Case report and review of the literature

Fares Antaki; Kenan Bachour; Milanne Trottier; Laurent Létourneau-Guillon; Jacinthe Rouleau

doi:10.1016/j.idcr.2021.e01237

Neurosyphilis masquerading as oculomotor nerve palsy in a healthy middle-aged man: Case report and review of the literature

IDCases. 2021 Jul 24:25:e01237. doi: 10.1016/j.idcr.2021.e01237. eCollection 2021.

Authors

Fares Antaki¹, Kenan Bachour¹, Milanne Trottier², Laurent Létourneau-Guillon², Jacinthe Rouleau¹

Affiliations

¹ Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada.
² Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada.

Abstract

Acquired isolated oculomotor nerve palsy (ONP) is a commonly encountered clinical entity in ophthalmology. While most cases are due to microvascular ischemia, the diagnosis of ONP requires careful evaluation for alternate life-threatening etiologies. We present a case of isolated complete pupil-involving ONP in a healthy 47-year-old man in whom aneurysmal compression was initially suspected. Investigations later revealed a diagnosis of neurosyphilis. Neurosyphilis is an extremely rare cause of isolated ONP and seldom reported in the literature. Timely recognition of this disease by ophthalmologists can help orient patients to the appropriate neurology and infectious disease services they need.

Keywords: CNS infections; Cranial nerve palsy; Neurology; Neuroradiology; Neurosyphilis; Oculomotor nerve palsy; Ophthalmology; Sexually transmitted infections.

Publication types

Case Reports