Acute unilateral peripheral vestibulopathy in neurosyphilis

Abstract

Introduction: Neurosyphilis producing basal meningitis presenting as sequential transient cranial nerve palsies was well recognized before the antibiotic era.

Objective: To report two patients presenting with acute unilateral peripheral vestibulopathy due to syphilitic basal meningitis.

Results: In Case 1 basal meningitis occurred early in the secondary phase of the infection, in Case 2 in the late latent phase. The diagnosis was not made immediately in either case; in Case 1 after previous presentation with increasing hearing loss and then with facial palsy and then a subsequent presentation with optic neuritis; in Case 2 after investigation for possible lymphoma.

Conclusion: Syphilitic basal meningitis in either the secondary or in the latent phase can present as acute unilateral peripheral vestibulopathy with transient involvement of the facial or auditory nerve.

Keywords: Acute unilateral peripheral vestibulopathy; Basal meningitis; Cranial nerve palsy; Neurosyphilis.