title: A complex neurological presentation of syphilis.
abstract: Syphilis is a contagious sexually transmitted infection notable for its complex array of systemic presentations. It is caused by the spirochaete Treponema pallidum and although once considered to be a largely historical condition in the UK, the recent rise in incidence makes syphilis increasingly relevant when considering unusual presentations in at-risk patients. The disease has three stages: primary, secondary and tertiary. The tertiary stage is associated with a plethora of neurological features ranging from psychosis to seizure caused by direct invasion of the spirochaete into the central nervous system. Here we describe the case of a 45-year-old man presenting with tonic clonic seizures on a background of balance and visual problems. Following normal examination and routine investigations further serology confirmed a diagnosis of neurosyphilis. The patient was started on appropriate treatment and made an excellent clinical recovery.
authors.affiliation: Central Middlesex Hospital, London, UK. maxkamath@gmail.com
authors.forename: Max
authors.initials: M
authors.lastname: Kamath
authors.forename: Maleeha
authors.initials: M
authors.lastname: Rizvi
authors.forename: Jenny
authors.initials: J
authors.lastname: O'Nions
authors.forename: Gary
authors.initials: G
authors.lastname: Brook
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis*
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