Neurosyphilis as a great imitator: a case report

BMC Res Notes. 2016 Jul 28:9:372. doi: 10.1186/s13104-016-2176-2.

Abstract

Background: Neurosyphilis is defined as any involvement of the central nervous system by the bacterium Treponema pallidum. Movement disorders as manifestations of syphilis have been reported quite rarely.

Case presentation: We report a case of a 42-year-old Russian man living in Estonia with rapidly progressive dementia and movement disorders manifesting as myoclonus, cerebellar ataxia and parkinsonism. The mini mental state examination score was 12/30. After excluding different neurodegenerative causes, further diagnostic testing was consistent with neurosyphilis. Treatment with penicillin was started and 6 months later his mini mental state examination score was 25/30 and he had no myoclonus, parkinsonism or cerebellar dysfunction.

Conclusion: Since syphilis is easily diagnosed and treatable, it should be considered and tested in patients with cognitive impairment and movement disorders.

Keywords: Dementia; Movement disorders; Neurosyphilis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Diagnosis, Differential
  • Humans
  • Male
  • Myoclonic Cerebellar Dyssynergia / diagnosis*
  • Myoclonic Cerebellar Dyssynergia / physiopathology
  • Neurosyphilis / diagnosis*
  • Neurosyphilis / drug therapy*
  • Neurosyphilis / microbiology
  • Neurosyphilis / physiopathology
  • Parkinsonian Disorders / diagnosis*
  • Parkinsonian Disorders / physiopathology
  • Penicillins / therapeutic use*
  • Treatment Outcome
  • Treponema pallidum / drug effects
  • Treponema pallidum / growth & development
  • Treponema pallidum / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Penicillins

Supplementary concepts

  • Hunt's syndrome