A case of meningovascular syphilis presenting with bilateral oculomotor nerve palsy, cerebral aneurysm, and cerebral hemorrhage

The patient was a 32-year-old man with no HIV infection and possible syphilis infection at the age of 22 years. At the age of 29 years, he visited an ophthalmologist for diplopia due to right oculomotor nerve palsy. He underwent diplopia strabismus surgery for unexplained oculomotor nerve palsy. At...

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Bibliographic Details
Published inRinsho Shinkeigaku Vol. 62; no. 11; pp. 873 - 876
Main Authors Soeda, Shin, Onoue, Hiroyuki, Shinmura, Yawara, Ebihara, Satoshi, Suzuki, Tone, Akaiwa, Yasuhisa, Miyamoto, Tomoyuki
Format Journal Article
LanguageJapanese
Published Societas Neurologica Japonica 26.11.2022
Subjects
cerebral aneurysm
cerebral hemorrhage
meningovascular syphilis
neurosyphilis
oculomotor nerve palsy
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Summary:The patient was a 32-year-old man with no HIV infection and possible syphilis infection at the age of 22 years. At the age of 29 years, he visited an ophthalmologist for diplopia due to right oculomotor nerve palsy. He underwent diplopia strabismus surgery for unexplained oculomotor nerve palsy. At the age of 31 years, he had a left oculomotor nerve palsy and was referred to our department. He was diagnosed with neurosyphilis based on positive serum and cerebrospinal fluid syphilis antibodies. MRI showed aneurysm, asymptomatic cerebral hemorrhage, and contrast enhancement of the left oculomotor nerve, leading to the diagnosis of meningovascular syphilis. The patient’s symptoms improved with penicillin and corticosteroids. The oculomotor nerve palsy may be due to microcirculatory disorder caused by syphilitic cerebral endarteritis.
ISSN:0009-918X
1882-0654
DOI:10.5692/clinicalneurol.cn-001784