title: Neurosyphilis presenting with psychotic symptoms and status epilepticus.
abstract: The widespread use of antibiotics in recent years has considerably modified the clinical features of neurosyphilis. Presently, atypical or masked forms of this disease often occur and obscure diagnosis, despite a thorough history and clinical work-up. Here, we report a patient with neurosyphilis presenting with psychotic symptoms who then developed status epilepticus and left limb weakness. Diffusion-weighted magnetic resonance imaging showed hyperintensity involving the right parietal, occipital and temporal lobes and the thalamus. Subsequent serological and cerebrospinal fluid tests confirmed the diagnosis of neurosyphilis. The coexistence of meningovascular syphilis, syphilitic meningitis, and general paresis resulted in the complex manifestation of this patients' condition, as described here in terms of the unusual presentation, evolution, and final diagnosis.
authors.affiliation: Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Anshan Avenue 154, Tianjin 300052, China. yaoyuanrong@hotmail.com
authors.forename: Yuanrong
authors.initials: Y
authors.lastname: Yao
authors.forename: Enqiang
authors.initials: E
authors.lastname: Huang
authors.forename: Bingdi
authors.initials: B
authors.lastname: Xie
authors.forename: Yan
authors.initials: Y
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D008297:Male; D009494:Neurosyphilis / Q000150:complications* / Q000473:pathology; D011618:Psychotic Disorders / Q000209:etiology* / Q000473:pathology; D013226:Status Epilepticus / Q000209:etiology* / Q000473:pathology