title: Periodic Lateralized Epileptiform Discharges (PLEDs) in Patients With Neurosyphilis and HIV Infection.
abstract: Periodic lateralized epileptiform discharges (PLEDs) are an electroencephalographic pattern recorded in the setting of a variety of brain abnormalities. It is best recognized for its association with acute viral encephalitis, stroke, tumor, or latestatus epilepticus. However, there are other conditions that have been recognized as the underlying pathology for PLEDs such as alcohol withdrawal, Creutzfeldt-Jacob disease, anoxic brain injury, and hemiplegic migraine. However, there are only rare case reports of PLEDs in patients with neurosyphilis. Here, we report 2 patients presenting with encephalopathy and seizures with PLEDs, ipsilateral or contralateral to their main brain magnetic resonance imaging abnormalities. Further workup revealed neurosyphilis in both patients, one in association with human immunodeficiency virus (HIV) infection. Given the increasing incidence of neurosyphilis with or without HIV infection, these cases suggest neurosyphilis as a consideration in the differential for patients presenting with PLEDs.
authors.affiliation: Department of Neurology, Georgetown University Hospital, Washington, DC, USA Department of Systems Physiology of Learning, Leibniz Institute for Neurobiology, Magdeburg, Germany.
authors.forename: Kentaroh
authors.initials: K
authors.lastname: Takagaki
authors.affiliation: Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Morales
authors.affiliation: Department of Neurology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Vitantonio
authors.affiliation: Department of Radiology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Berkowitz
authors.affiliation: Department of Neurology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: William L
authors.initials: WL
authors.lastname: Bell
authors.affiliation: Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Princy N
authors.initials: PN
authors.lastname: Kumar
authors.affiliation: Department of Neurology, Georgetown University Hospital, Washington, DC, USA motamedi@georgetown.edu.
authors.forename: Gholam K
authors.initials: GK
authors.lastname: Motamedi
mesh_terms: D000368:Aged; D001683:Biological Clocks; D001921:Brain / Q000503:physiopathology*; D004569:Electroencephalography / Q000379:methods; D018792:Encephalitis, Viral / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009494:Neurosyphilis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*
keywords: HIV; cerebrospinal fluid; neurosyphilis; periodic lateralized epileptiform discharges (PLEDs)