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{"work":{"id":123282240,"created_at":"2024-08-27T03:49:38.876-07:00","from_world_paper_id":258645627,"updated_at":"2025-01-13T04:10:16.724-08:00","_data":{"publisher":"Journal of Nepal Medical Association (JNMA)","ai_abstract":"The paper discusses the atypical presentations of neurosyphilis, emphasizing the challenges in diagnosis due to its rarity and the modified forms that have emerged following widespread antibiotic use. A case report illustrates a 40-year-old man's cognitive impairments and seizures, ultimately diagnosed as neurosyphilis through serological testing. The discussion highlights the importance of recognizing various symptoms that may masquerade as psychiatric disorders, advocating for clinicians to maintain a high index of suspicion and conduct regular serological testing.","publication_date":"2003,,","publication_name":"Journal of Nepal Medical Association"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"low","language":"en","title":"Atypical Presentation of Neurosyphilis","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true,"seo_quality":null}}["work"]; window.loswp.workCoauthors = [312198311]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "control"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":117750627,"attachmentType":"pdf"}"><img alt="First page of “Atypical Presentation of Neurosyphilis”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/117750627/mini_magick20240827-1-8wicka.png?1724755786" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Atypical Presentation of Neurosyphilis</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="312198311" href="https://independent.academia.edu/AbdulKhalid148"><img alt="Profile image of Abdul Khalid" class="ds-work-card--author-avatar" src="https://0.academia-photos.com/312198311/155918694/145544811/s65_abdul.khalid.jpeg" />Abdul Khalid</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2003, Journal of Nepal Medical Association</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">1 page</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 123282240; 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A case report illustrates a 40-year-old man's cognitive impairments and seizures, ultimately diagnosed as neurosyphilis through serological testing. The discussion highlights the importance of recognizing various symptoms that may masquerade as psychiatric disorders, advocating for clinicians to maintain a high index of suspicion and conduct regular serological testing.</p></div></div><div class="ds-top-related-works--grid-container"><div class="ds-related-content--container ds-top-related-works--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="0" data-entity-id="21376611" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/21376611/Neurosyphilis_Report_of_Two_Patients">Neurosyphilis; Report of Two Patients</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="15833472" href="https://cukurova.academia.edu/LTamam">Lut Tamam</a></div><p class="ds-related-work--abstract ds2-5-body-sm">Purpose: Syphilis is a treatable disease provided a diagnose is made at an early stage, this way, the central nervous system complications that can be ob served years after first inoculation can be avoided.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neurosyphilis; Report of Two Patients","attachmentId":41841211,"attachmentType":"pdf","work_url":"https://www.academia.edu/21376611/Neurosyphilis_Report_of_Two_Patients","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/21376611/Neurosyphilis_Report_of_Two_Patients"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="38074606" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/38074606/Neurosyphilis_Still_a_Diagnostic_and_Therapeutic_Challenge">Neurosyphilis – Still a Diagnostic and Therapeutic Challenge</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="98198066" href="https://independent.academia.edu/JNixon2">Jacobs Publishers</a></div><p class="ds-related-work--abstract ds2-5-body-sm">Neurosyphilis results from an infection of the brain, meninges and/or the spinal cord and may develop in persons in whom a manifest syphilis has passed untreated. The clinical manifestations are often diverse and may present as a psychiatric disorder. This article reports two cases with neurosyphilis who were followed for 33 and 21 years respectively. In one of these cases neu-ropathological findings are presented. Retrospective evaluations of all medical records were performed to characterize psychiatric and other clinical features, laboratory and brain imaging findings. Both patients presented a variety of psychiatric manifestations and were initially misdiagnosed. The diagnosis was based on positive serology, cerebrospinal fluid, and neuropsychiatric symptoms and supported by brain imaging. There was a marked improvement in both patients after penicillin therapy. In the case with autopsy mixed brain pathology with atrophy of the frontotemporal areas and advanced vascular pathology was seen. These cases emphasize the importance of screening for syphilis, especially in patients with unexplained psychiatric and neuro-logical symptoms and signs.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neurosyphilis – Still a Diagnostic and Therapeutic Challenge","attachmentId":58100643,"attachmentType":"pdf","work_url":"https://www.academia.edu/38074606/Neurosyphilis_Still_a_Diagnostic_and_Therapeutic_Challenge","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/38074606/Neurosyphilis_Still_a_Diagnostic_and_Therapeutic_Challenge"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="104237515" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/104237515/Three_cases_of_neurosyphilis_diagnosed_in_the_21st_century_A_case_report">Three cases of neurosyphilis diagnosed in the 21st century: A case report</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="236290341" href="https://independent.academia.edu/danielamusat9">daniela musat</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Experimental and Therapeutic Medicine</p><p class="ds-related-work--abstract ds2-5-body-sm">In the last decades, it has been considered that syphilis and its complications, including neurological damage, are able to be kept under control with proper epidemiological management. However, socioeconomic changes and the problem of antibiotic resistance have brought it back into the focus of clinicians. The present study reports on the cases of three male patients of different ages (28, 76 and 51 years) from different social backgrounds and occupations were provided (first patient, nurse; second patient, pensioner; third patient, navigator); they were confirmed to have neurosyphilis, clinically, paraclinically and by imaging. The complications that may occur in the evolution of the disease but also the beneficial effects of targeted, antisyphilitic and symptomatic therapy were outlined. The purpose of the present study was to highlight issues of major importance regarding neurosyphilis, particularly for neurologists, for whom diagnosis may be challenging. It is key for the neurologist to understand the clinical manifestations and limitations of current diagnostic tests. It is important to consider that a positive rapid plasma reagin test result without confirmation of the presence of Treponema pallidum antibodies in the cerebrospinal fluid may represent a false-positive screening test.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Three cases of neurosyphilis diagnosed in the 21st century: A case report","attachmentId":104020785,"attachmentType":"pdf","work_url":"https://www.academia.edu/104237515/Three_cases_of_neurosyphilis_diagnosed_in_the_21st_century_A_case_report","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/104237515/Three_cases_of_neurosyphilis_diagnosed_in_the_21st_century_A_case_report"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="11066809" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/11066809/Criteria_for_the_management_of_neurosyphilis">Criteria for the management of neurosyphilis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="26758434" href="https://unsrat.academia.edu/evanthomas">evan thomas</a></div><p class="ds-related-work--metadata ds2-5-body-xs">American Journal of Medicine, 1951</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Criteria for the management of neurosyphilis","attachmentId":46926777,"attachmentType":"pdf","work_url":"https://www.academia.edu/11066809/Criteria_for_the_management_of_neurosyphilis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/11066809/Criteria_for_the_management_of_neurosyphilis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="98350283" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/98350283/A_Vintage_Case_with_a_Novel_Treatment_for_Neurosyphilis_A_Case_Report">A Vintage Case with a Novel Treatment for Neurosyphilis: A Case Report</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33704867" href="https://amu-in.academia.edu/SZRahman">Syed Ziaur Rahman</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2019</p><p class="ds-related-work--abstract ds2-5-body-sm">Syphilis is a multisystem chronic infection caused by Treponema pallidum. The infection has a multitude of clinical presentation and is often referred to as the ‘great imitator’. Neurosyphilis (NS) can have different presentation such as meningitis along with meningovascular complications. With the advent of antibiotic penicillin procaine, however, the number of new syphilitic patients have been decreased, but still few new cases are being reported occasionally. Since the penicillin is now rarely available in the local drug market, the reported rare case of Neurosyphilis at tertiary care hospital of North India was treated by another antibiotic Ceftriaxone successfully after confirmation by syphilis serology and attenuation of signs and symptoms.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"A Vintage Case with a Novel Treatment for Neurosyphilis: A Case Report","attachmentId":99725630,"attachmentType":"pdf","work_url":"https://www.academia.edu/98350283/A_Vintage_Case_with_a_Novel_Treatment_for_Neurosyphilis_A_Case_Report","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/98350283/A_Vintage_Case_with_a_Novel_Treatment_for_Neurosyphilis_A_Case_Report"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="10846844" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/10846844/Neurosyphilis_and_Clinical_Variants">Neurosyphilis and Clinical Variants</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="26355432" href="https://independent.academia.edu/MarcusViniviusOliveira">Marcus Vinivius Oliveira</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Revista Neurociências, 2012</p><p class="ds-related-work--abstract ds2-5-body-sm">Rev Neurocienc 2012;20(4):546-551 relato de caso 546 RESUMO Introdução. A neurossífilis é uma manifestação pouco frequente da infecção do sistema nervoso central (SNC) pelo Treponema pallidum. Casos. Nós relatamos três casos de neurossífilis. O caso 1 apresentavase com envolvimento ocular: atrofia ótica à direita e neurite ótica à esquerda; o caso 2 uma forma meningovascular com Acidente Vascular Cerebral isquêmico; e o caso 3, uma forma meníngea, tinha como queixa principal cefaléias. Discussão. Os casos relatados apresentavam distintas formas de neurossífilis. O diagnóstico sorológico depende da presença de anticorpos: Veneral Disease Research Laboratory (VDRL) -não específico -e/ou Fluorescent Treponemal Antibody Absorption (FTA-ABS) -específico. Conclusão. Nos casos acima o FTA-ABS no líquor foi uma ferramenta importante para o diagnóstico de neurossífilis, mesmo nos pacientes que apresentam VDRL sérico negativo. Unitermos. Sífilis, Sistema Nervoso Central, Neurossífilis. Citação. Moro A, Bresciani AP, Oliveira MV, Albino PHC, Bertotti MM, Bruscato AM, Queiroz LP, Mattosinho Filho P. Neurosífilis e Variantes Clínicas.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neurosyphilis and Clinical Variants","attachmentId":47079479,"attachmentType":"pdf","work_url":"https://www.academia.edu/10846844/Neurosyphilis_and_Clinical_Variants","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/10846844/Neurosyphilis_and_Clinical_Variants"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="123107483" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/123107483/YOUNG_PATIENT_PRESENTED_WITH_IMBALANCE_DIAGNOSED_AS_A_NEUROSYPHILIS">YOUNG PATIENT PRESENTED WITH IMBALANCE DIAGNOSED AS A NEUROSYPHILIS</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="320509347" href="https://independent.academia.edu/NationalJournalofMedicalResearch">National Journal of Medical Research</a></div><p class="ds-related-work--metadata ds2-5-body-xs">National Journal of Medical Research, 2014</p><p class="ds-related-work--abstract ds2-5-body-sm">A 30 year old female patient was presented with a history of weakness of both lower Limbs, sense of imbalance while standing and difficulty in walking with no significant past history. Upon investigation for paraperesis, the patient found to have a positive serology for syphilis. The possibility of neurosyphilis was considered, which was later confirmed by positive serology for cerebrospinal fluid and diagnosed as tabes dorsalis. The case is lengthly discussed in this report to emphasize the presence of syphilis in 21st century and for awareness of florid manifestations of tabes dorsalis for early diagnosis and proper treatment of this disabling condition.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"YOUNG PATIENT PRESENTED WITH IMBALANCE DIAGNOSED AS A NEUROSYPHILIS","attachmentId":117620533,"attachmentType":"pdf","work_url":"https://www.academia.edu/123107483/YOUNG_PATIENT_PRESENTED_WITH_IMBALANCE_DIAGNOSED_AS_A_NEUROSYPHILIS","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/123107483/YOUNG_PATIENT_PRESENTED_WITH_IMBALANCE_DIAGNOSED_AS_A_NEUROSYPHILIS"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="12534124" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/12534124/Neurosyphilis_in_an_eight_year_old_child_Usefulness_of_the_SPECT_study">Neurosyphilis in an eight-year-old child: Usefulness of the SPECT study</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="31426202" href="https://independent.academia.edu/JaimeAltcheh">Jaime Altcheh</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pediatric Neurology, 1998</p><p class="ds-related-work--abstract ds2-5-body-sm">An S-year-old boy with symptomatic late-onset congenital syphilis is reported. The child had been undertreated when he was 78 days of age, but his clinical and serologic follow-up did not occur until he was 3 years of age. At that time, he was asymptomatic, and cerebrospinal fluid disclosed not only hypercellularity but also a reactive Venereal Disease Research Laboratories test. Although he was then retreated at 4 years of age, he developed seizures. Cranial computed tomography and magnetic resonance imaging were normal, but two single photon emission computed tomography scans performed when he was 5 years of age and then 7 years of age demonstrated areas of hypoperfusion that closely agreed with the alterations on electroencephalograph. Brain single photon emission computed tomography was able to detect cerebral nervous system abnormalities in this young patient with neurosyphilis, whereas other image studies did not. 0 1998 by Elsevier Science Inc. All rights reserved.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neurosyphilis in an eight-year-old child: Usefulness of the SPECT study","attachmentId":46108350,"attachmentType":"pdf","work_url":"https://www.academia.edu/12534124/Neurosyphilis_in_an_eight_year_old_child_Usefulness_of_the_SPECT_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/12534124/Neurosyphilis_in_an_eight_year_old_child_Usefulness_of_the_SPECT_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="10737442" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/10737442/Intractable_Epilepsy_as_the_Initial_Manifestation_of_Neurosyphilis">Intractable Epilepsy as the Initial Manifestation of Neurosyphilis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="26172788" href="https://independent.academia.edu/Th%C3%A0nhPhan9">Thành Phan</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Epilepsia, 1999</p><p class="ds-related-work--abstract ds2-5-body-sm">Summary: A 29-year-old man experienced intractable partial seizures as the initial manifestation of neurosyphilis. The diagnosis was made after the onset of dementia 9 months later. Both the epilepsy and dementia resolved with penicillin therapy. Syphilis should be considered in patients with adult-onset focal epilepsy, particularly if there is associated dementia. Treatment may be successful even when the diagnosis is delayed.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Intractable Epilepsy as the Initial Manifestation of Neurosyphilis","attachmentId":47165951,"attachmentType":"pdf","work_url":"https://www.academia.edu/10737442/Intractable_Epilepsy_as_the_Initial_Manifestation_of_Neurosyphilis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/10737442/Intractable_Epilepsy_as_the_Initial_Manifestation_of_Neurosyphilis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="53821780" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/53821780/Neurosyphilis_Presenting_with_Anxiety_A_Case_Report">Neurosyphilis Presenting with Anxiety: A Case Report</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="151761059" href="https://hcmussh.academia.edu/NhuTruong">Nhu Truong</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cureus</p><p class="ds-related-work--abstract ds2-5-body-sm">The number of cases of late and late latent syphilis in the United States is on the rise. This diagnosis is often forgotten when an elderly patient is being worked up for altered mental status. Rarely does a 70-year-old male with neurosyphilis present simply with anxiety. Due to the decreased severity of the presentation, this patient was sent home from the emergency department multiple times until the anxiety progressed to psychosis. He was finally admitted with delirium, suicidal ideation, and paranoia. A routine Treponema pallidum antibody test returned positive and a further workup of confirmatory lab work, a thorough neurological exam, and magnetic resonance imaging (MRI) revealed a chronic syphilis infection. This case study explores signs in the history and physical examination that should quickly prompt a provider to consider neurosyphilis in their differential. This patient presented with Argyll-Robertson pupils and significant risk factors. The goal of this discussion is to bring awareness to this infrequent presentation and share simple examination techniques that could have been used to diagnose and treat this patient's symptoms more promptly. In doing so, the hope is to raise awareness for the diagnosis of neurosyphilis, especially in the elderly patient presenting with psychiatric symptoms.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neurosyphilis Presenting with Anxiety: A Case Report","attachmentId":70483391,"attachmentType":"pdf","work_url":"https://www.academia.edu/53821780/Neurosyphilis_Presenting_with_Anxiety_A_Case_Report","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/53821780/Neurosyphilis_Presenting_with_Anxiety_A_Case_Report"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":117750627,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":117750627,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_117750627" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. 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Signal Intensity and Significant Atrophy in Left Amygdala/Hippocampal Region","attachmentId":97497608,"attachmentType":"pdf","work_url":"https://www.academia.edu/95269658/A_Neurosyphilis_Case_Presenting_with_Cognitive_Dysfunction_Epileptic_Seizures_High_Signal_Intensity_and_Significant_Atrophy_in_Left_Amygdala_Hippocampal_Region","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/95269658/A_Neurosyphilis_Case_Presenting_with_Cognitive_Dysfunction_Epileptic_Seizures_High_Signal_Intensity_and_Significant_Atrophy_in_Left_Amygdala_Hippocampal_Region"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="5" data-entity-id="95982031" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/95982031/Treatment_of_Neurosyphilis">Treatment of Neurosyphilis</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="43873765" href="https://independent.academia.edu/RichardRothenberg">Richard Rothenberg</a></div><p class="ds-related-work--metadata ds2-5-body-xs">BMJ, 1947</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Treatment of 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data-collection-position="13" data-entity-id="52970880" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/52970880/Parkinsonism_secondary_to_neurosyphilis">Parkinsonism secondary to neurosyphilis</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38357381" href="https://independent.academia.edu/MarianaSpitz">Mariana Spitz</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Movement Disorders, 2009</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Parkinsonism secondary to neurosyphilis","attachmentId":69975742,"attachmentType":"pdf","work_url":"https://www.academia.edu/52970880/Parkinsonism_secondary_to_neurosyphilis","alternativeTracking":true}"><span 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