An Early Presentation of Neurosyphilis Manifesting as Cranial Polyneuropathies: A Case Report

A. Ravichandran, Katie Reming, K. Sivakumar, H. Yacoub
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Abstract

Neurosyphilis (NS) is a rarely reported disease, with neurological manifestations occurring in the late stages of the infection. The incidence of NS has steadily increased, particularly with increased cases of human immunodeficiency virus (HIV) infection among homosexual partners, and can occur at any stage of the disease. In this case report, we present a 53-year-old homosexual man with HIV who presented with a gradual onset of vertigo over a course of 2 weeks, followed by gradual onset of multiple cranial neuropathies. Magnetic resonance imaging of the brain revealed pathological enhancement of multiple cranial nerves. Laboratory workup revealed reactive Venereal Disease Research Laboratory dilutional titer in the cerebrospinal fluid, supporting the diagnoses of NS. He was treated with intravenous penicillin with gradual resolution of symptoms. Our case illustrates that NS can occur with no known prior evidence or manifestation of the infection. The diagnosis of NS should be entertained in individuals with a known history of HIV and unexplained multiple cranial neuropathies. J Neurol Res. 2021;11(1-2):27-31 doi: https://doi.org/10.14740/jnr650
早期表现为颅多神经病变的神经梅毒一例报告
神经梅毒(NS)是一种很少报道的疾病,在感染后期出现神经系统症状。NS的发病率稳步上升,特别是在同性恋伴侣中感染人类免疫缺陷病毒(HIV)的病例增加,并且可以发生在疾病的任何阶段。在这个病例报告中,我们提出了一个53岁的男同性恋艾滋病毒感染者,在2周的时间里,他出现了逐渐发作的眩晕,随后出现了逐渐发作的多发性颅神经病变。脑部核磁共振显示多根脑神经病理强化。实验室检查显示脑脊液有反应性性病研究实验室稀释滴度,支持NS的诊断。经静脉注射青霉素治疗,症状逐渐缓解。我们的病例表明,NS可以在没有已知的先前证据或感染表现的情况下发生。对于已知HIV病史和不明原因多发性颅脑神经病变的患者,应考虑NS的诊断。中华神经科学杂志。2021;11(1-2):27-31 doi: https://doi.org/10.14740/jnr650
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