A 17-year-old woman presented with ataxia, refractory epilepsy and progressive cognitive decline since the age of eight. A brain MRI showed white matter abnormalities and atrophy (Figures 1 and 2). Her mother had positive tests for syphilis in her prenatal screening, but had not received any treatment. In our patient, serum VDRL (1:16) and IgG-FTA-ABS were positive. Her cerebrospinal fluid showed a slight increase in protein level, negative VDRL and positive FTA-ABS tests. Our diagnosis was late congenital syphilis with atypical brain abnormalities. We should be aware of this disorder and include it in the differential diagnosis of subacute neurological syndromes with frontal and temporal lesions on brain MRI11. Mignarri A, Arrigucci U, Coleschi P, Bilenchi R, Federico A, Dotti M. Temporal lobe abnormalities in neurosyphilis. Pract Neurol. 2014; 14 (6): 449-50. https://doi.org/10.1136/practneurol-2014-000927
https://doi.org/10.1136/practneurol-2014...
,22. Hama K, Ishiguchi H, Tuji T, Miwa H, Kondo T. Neurosyphilis with mesiotemporal magnetic resonance imaging abnormalities. Inter Med. 2008;47 (20): 1813-7...
Coronal T2 MRI sequence: brain atrophy and hyperintensities of the temporal and frontal lobes
References
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1Mignarri A, Arrigucci U, Coleschi P, Bilenchi R, Federico A, Dotti M. Temporal lobe abnormalities in neurosyphilis. Pract Neurol. 2014; 14 (6): 449-50. https://doi.org/10.1136/practneurol-2014-000927
» https://doi.org/10.1136/practneurol-2014-000927 -
2Hama K, Ishiguchi H, Tuji T, Miwa H, Kondo T. Neurosyphilis with mesiotemporal magnetic resonance imaging abnormalities. Inter Med. 2008;47 (20): 1813-7.
Publication Dates
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Publication in this collection
Sept 2017
History
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Received
05 Nov 2016 -
Reviewed
25 June 2017 -
Accepted
04 July 2017