Nonconvulsive status epilepticus resulting from Jarisch-Herxheimer reaction in a patient with neurosyphilis.
We report a case of Jarisch-Herxheimer reaction in a patient with neurosyphilis, which was complicated by nonconvulsive status epilepticus. The EEG features suggested a focal seizure onset, although the patient's MRI was normal. JHR is common in the treatment of neurosyphilis, but usually produces only transient systemic constitutional symptoms. Neurologic deterioration is rare, but can be dramatic, as in our patient. NCSE should be considered as an explanation for persistent obtundation and transient focal neurologic findings in this setting.
Kojan
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S
Department of Neurology, University of Texas Southwestern Medical Center, Dallas 75235-9036, USA.
Van Ness
P C
PC
Diaz-Arrastia
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R
D002540:Cerebral Cortex / Q000187:drug effects / Q000503:physiopathology; D004569:Electroencephalography / Q000187:drug effects*; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D009494:Neurosyphilis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D010406:Penicillins / Q000008:administration & dosage / Q000009:adverse effects*; D013226:Status Epilepticus / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology
D010406:Penicillins