Neurosyphilis with mesiotemporal magnetic resonance imaging abnormalities.
We describe a patient with mesial temporal T2-weighted image hyperintensity on magnetic resonance imaging that mimicked paraneoplastic limbic encephalitis. The patient showed pupillary abnormalities suggestive of a diagnosis of neurosyphilis, and the diagnosis was supported by the results of a serum Treponema pallidum hemagglutination assay (TPHA) and cerebrospinal fluid examination. Making a diagnosis of neurosyphilis is occasionally difficult because of the variety of clinical and imaging findings. Appropriate diagnosis and commencing adequate treatment are needed for a good prognosis; thus, neurosyphilis should be included in the differential diagnosis of mesiotemporal magnetic resonance imaging abnormalities.
Hama
Kiwa
K
Department of Neurology, Wakayama Medical University, Wakayama. kiwasuga@wakayama-med.ac.jp
Ishiguchi
Hiroshi
H
Tuji
Tomikimi
T
Miwa
Hideto
H
Kondo
Tomoyoshi
T
D003937:Diagnosis, Differential; D006801:Humans; D020363:Limbic Encephalitis / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis* / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology*