Neurosyphilis Concurrently Presenting With Limbic Encephalitis and Normal Pressure Hydrocephalus: A Case Report.
Naoki Obata, Kenshi Terajima, Gen Miura et al.
✦ AI-curated · Sources linked
Case in brief
A 47-year-old man presented with cognitive decline, gait disturbance, and urinary incontinence. Imaging revealed ventricular enlargement and high signal intensity in the medial temporal lobes. Positive serological and cerebrospinal fluid tests confirmed neurosyphilis. He received intravenous benzylpenicillin and methylprednisolone, leading to improvement in gait and urinary symptoms, but cognitive impairment remained largely unchanged.
What made this case unusual
The case uniquely combined early-onset dementia with limbic encephalitis and normal pressure hydrocephalus, highlighting the complex presentation of neurosyphilis.
Diagnostic / clinical pearl
Clinicians should consider neurosyphilis in patients presenting with cognitive decline and atypical neuroimaging findings, as it may be easily overlooked.
Why it matters
Recognizing the diverse manifestations of neurosyphilis can lead to timely diagnosis and treatment, potentially improving patient outcomes.