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Abhishek Lenka, Naveen Thota, Albert Stezin, Pramod Kumar Pal, Ravi Yadav
BACKGROUND: Involvement of the central nervous system in patients with syphilis (neurosyphilis) may result in several neuropsychiatric symptoms. Rarely, patients with neurosyphillis may develop movement disorders with different phenomenology. Subtle orofacial dyskinesias have been reported in patients with neurosyphilis, known as the candy sign. CASE REPORT: We describe a patient with neurosyphilis who presented with severe orofacial involuntary movements. DISCUSSION: Our patient had orofacial movements at presentation and severity of the movements was much higher than the candy sign that has been reported in patients with neurosyphilis...
2017: Tremor and Other Hyperkinetic Movements
Adam Włodarczyk, Joanna Szarmach, Katarzyna Jakuszkowiak-Wojten, Maria Gałuszko-Węgielnik, Mariusz S Wiglusz
BACKGROUND: Neurosyphilis is an infection of the brain or spinal cord caused by Treponema pallidum. In the third phase of syphilis involving the central nervous system it may manifest in a widespread dysfunctions including psychiatric manifestations being often underestimated in the differential diagnosis. CASE REPORTS: Two patients demonstrating rapid cognitive decline as the primary symptom for neurosyphillis are described with particular focus on the diagnostic process complexity and adequate treatment delivery...
September 2017: Psychiatria Danubina
A Jolivet-Gougeon, M Bonnaure-Mallet
Spirochetes are suspected to be linked to the genesis of neurological diseases, including neurosyphillis or neurodegeneration (ND). Impaired iron homeostasis has been implicated in loss of function in several enzymes requiring iron as a cofactor, formation of toxic oxidative species, inflammation and elevated production of beta-amyloid proteins. This review proposes to discuss the link that may exist between the involvement of Treponema spp. in the genesis or worsening of ND, and iron dyshomeostasis. Proteins secreted by Treponema can act directly on iron metabolism, with hemin binding ability (HbpA and HbpB) and iron reductase able to reduce the central ferric iron of hemin, iron-containing proteins (rubredoxin, neelaredoxin, desulfoferrodoxin metalloproteins, bacterioferritins etc)...
November 21, 2016: Current Alzheimer Research
Shaffer R S Mok, Vivek Punjabi, David L Shklar
BACKGROUND: Normal pressure hydrocephalus (NPH) is composed of gait abnormalities, urinary incontinence and decline in mentation. It is uncommonly induced by syphilitic infection. CASE REPORT: A 76 year-old male present with gait disturbances, urinary incontinence, declining vision and cognition, with a known diagnosis of NPH. He underwent therapeutic lumbar puncture (LP), which demonstrated leukocytosis and elevated protein. Venereal disease research laboratory testing (VDRL) was reactive in a 1:64 dilution with positive fluorescent Treponemal Antibody (FTA-Abs)...
2012: American Journal of Case Reports
Imane Hajjaj, Najib Kissani
The incidence of seizures in neurosyphilis ranges from 14 to 60%, however, neurosyphillis presenting with status epilepticus (SE) is rare. We report the case of a 49 year old man with no history of epilepsy and with a 9-year history of untreated syphilitic chancre. He presented in October 2005 with four stereotyped epileptic seizures lasting less than 2 minutes followed by a prolonged seizure lasting 20 minutes without recovery of consciousness. He regained consciousness after admission in intensive care unit for SE management...
September 2010: Acta Neurologica Belgica
C M Peiró, N Caballer, C L Errando, S Moliner
A 64-year-old man suspected of having neurosyphillis suffered subarachnoid spinal and cerebral ventricular hemorrhage after a diagnostic lumbar puncture. The main risk factor was trauma occurring during a difficult puncture. Both the diagnosis and the subsequent laminectomy were delayed. Blood migrated to both lateral ventricles, complicating the clinical course, which ended in death. The need for rapid diagnosis and treatment in such cases is revealed by both images and clinical course. A pathophysiologic explanation for these hemorrhagic events is provided...
November 2003: Revista Española de Anestesiología y Reanimación
H Hirabayashi, H Hamano, Y Ohnuki, M Nitta, Y Shinohara
We report a 56-year-old female with chronic progressive sensory ataxic neuropathy presenting with alternating skew deviation on lateral gaze in the clinical course. She initially developed dysesthesias in the hands and feet asymmetrically, then gait disturbance developed over several months, and she was admitted to our hospital. Neurological examinations revealed profound deep sensory loss and mild superficial sensory disturbance with the absence of deep tendon reflexes, but muscular strength was completely preserved...
October 1997: Rinshō Shinkeigaku, Clinical Neurology
J Marín, J Aguilar, S Angulo, E Rodríguez, G Izquierdo
The different formulas on intrathecal secretion of IgG were evaluated in patients with active neurosyphillis (NS) who did not have HIV infection with the aim of knowing their usefulness and sensitivity in the follow up of response to treatment. Five HIV negative patients with defined criteria of active NS were analyzed. The QAib ratio (albumin LCR/serum x 1,000) and Tourtellotte, Schuller and Reiber formulas of intrathecal secretion and the Link's index were studied prior to and at 15 days and three months following treatment with high intravenous doses of penicillin G over 12 days...
October 1, 1994: Medicina Clínica
H Ramirez, C Martinez, J Oliva, C Montini
A sample of 228 patients with facial pain is reported in the present paper. Among them, 112 cases are typical idiopathic trigeminal neuralgias, 111 are cases of secondary facial pain (including 7 cases symptomatic trigeminal neuralgias) and 5 patients were classified as vascular facial pain. Among the 119 cases of clinically diagnosed trigeminal neuralgias there were 112 (94, 11%) with no evidence of organic cause. Only 7 cases (5.89%) were identified as organic, including 3 cases of bulbar and pontic vascular lesions, 2 cases of iatrogenic injuries following neurosurgery, 1 case of meningioma of the ponto-cerebellar angle and 1 case of neurosyphillis...
April 1989: Odontología Chilena
N Joyce-Clarke, A C Molteno
A prospective study of 148 cases of neurosyphillis revealed that 85 patients exhibited a modified 'forme fruste' of the disease. A high proportion of these patients had evidence of activity in the cerebrospinal fluid, while 6 patients have developed features which are diagnostic of neurosyphills. During the study a significant number of active seronegative cases were diagnosed and 11 patients have deteriorated on treatment.
January 7, 1978: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
H W Jaffe, S A Larsen, M Peters, D F Jove, B Lopez, A L Schroeter
We studied the potential usefulness of CSF treponemal tests in the diagnosis of neurosyphillis. The CSF was tested with the microhemagglutination test for Treponema pallidum (CSF-MHA-TP test) and with the CSF-FTA test by using undiluted CSF and CSF diluted in saline and in sorbent. In a prospective evaluation, of 177 nonsyphilitics, none had reactive CSF-MHA-TP tests and only one had a reactive CSF-FTA test. However, five of 15 syphilitics with no other evidence of neurosyphilis had reactive CSF-FTA tests. The CSF-FTA test reactivity appeared most likely when the titer of the serum FTA test was high...
February 1978: Archives of Internal Medicine
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