Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of relapsed neurosyphilis with progressive left hemiparesis

Takuya Nishina, M.D.1), Mami Uemori, M.D.1), Tomohiko Satou, M.D.1) and Akihiko Asano, M.D.1)

1)Department of Neurology, Nihonseimeisaiseikai Nissay Hospital

A 52-year-old man presented with progressive dementia and left hemiparesis. He was treated for neurosyphilis at 44 years old in another hospital. An initial MRI revealed a widespread high-intensity area in the right temporal lobe on DWI. Findings on MRA were normal. He was treated initially with intravenous edaravone and glyceol, but neurological finding did not improved. Serological tests of serum and CSF demonstrated high titers of antibodies to Treponema pallidum. He was treated for relapsed neurosyphilis with daily penicillin G injections without improvement. Penicillin G was switched to erythromycin. After administration of erythromycin, neurological symptoms improved and MRI abnormality showed progression. This case could be considered as Lissauer form of general paresis because of left hemiparesis and MRI findings. Neurosyphilis should be considered in a case with revealing high density area in DWI.
Full Text of this Article in Japanese PDF (654K)

(CLINICA NEUROL, 58: 395|398, 2018)
key words: hemiparesis, Lissauer form of general paresis, MRI

(Received: 23-Jun-17)