title: Neurosyphilis presenting as a new onset lateralized movement disorder.
abstract: We report a unique and illustrative case of a 52-year-old man with neurosyphilis presenting as subacute hemichorea, and discuss a vascular, metabolic or inflammatory origin. A broad range of neurological findings may be linked to neurosyphilis, potentially complicating its diagnosis. We propose that new onset lateralized movement disorders may constitute the initial clinical presentations of neurosyphilis, and provide evidence for striatal hypermetabolism pointing to direct inflammatory, syphilitic changes as the underlying pathophysiological mechanism. Neurosyphilis is no longer a common disorder, but the prevalence of syphilis is rising again in Western countries and its past reputation as the great imitator should not be forgotten.
authors.affiliation: Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Pfender
authors.affiliation: Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Linnebank
authors.affiliation: Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland; Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Sommerauer
authors.affiliation: Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland. Electronic address: alexander.tarnutzer@usz.ch.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Tarnutzer
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D009494:Neurosyphilis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D010406:Penicillins / Q000008:administration & dosage
chemical_list: D010406:Penicillins
keywords: Hemichorea; Movement disorder; Neuroimaging; Neurological infectious disease; Neurosyphilis