Syphilitic normal pressure hydrocephalus

Pedersen, K. K.; Sørensen, Per Soelberg; Ankerhus, Jørgen; Danielsen, U. T.

doi:10.1007/bf01406018

Cited by 11 publications

(6 citation statements)

References 7 publications

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“…14 It is important to recognize that neurosyphilis can promote a seizure disorder 17,18 and the development of seizure activity in Case 2 helped to identify the true cause of the patient's presentation. Of particular interest, in our second patient, is the recognition of what has been termed "syphilitic normal pressure hydrocephalus" 19 as well as the potential for response to intravenous penicillin. 20 In this case, there was not only the finding of a diffusely prominent ventricular system, but also prominent cortical atrophy with periventricular white matter changes that could well reflect periventricular absorption of the cerebrospinal fluid.…”

Section: Discussionmentioning

confidence: 97%

Neuroimaging Findings in Neurosyphilis

Fadil

Gonzalez‐Toledo

Kelley

et al. 2006

Journal of Neuroimaging

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We report two cases of neurosyphilis with atypical clinical presentations that were compounded by atypical neuroimaging findings. In the first case, MRI brain scan findings were felt to be compatible with mesial temporal sclerosis or herpes simplex encephalitis. The second patient presented with a clinical picture compatible with normal pressure hydrocephalus as well as some degree of ventricular enlargement and prominent periventricular white matter changes by MRI brain scan. He actually underwent ventriculo-peritoneal shunting prior to determination that he had active syphilitic involvement of the central nervous system. Neurosyphilis, "the great imitator," is not only capable of mimicking various other neurological disease clinical presentations, it can also mimic neuroimaging features of various other disease processes as well.

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Section: Discussionmentioning

confidence: 97%

Neuroimaging Findings in Neurosyphilis

Fadil

Gonzalez‐Toledo

Kelley

et al. 2006

Journal of Neuroimaging

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show abstract

Section: Discussionmentioning

confidence: 99%

“…NPH secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation [3] and uncommon neuroimaging findings [4]. Pedersen et al, 1979, described a case of NPH secondary to syphilis that improved significantly with antibiotics [3]. A diagnosis of NPH is made when its triad of signs and symptoms (gait apraxia, dementia and urinary incontinence) is present together with an opening CSF pressure of less than 18 cm H 2 O and ventricular dilation that cannot be attributed exclusively to cerebral atrophy.…”

Section: Discussionmentioning

confidence: 99%

“…In the late stages of the disease, there may be involvement of the spinal cord and cerebral cortex, causing tabesdorsalis or general paresis, which is also known as paralytic dementia [1]. Other presentations of neurosyphilis have been described, such as limbic encephalitis [2] and normal pressure hydrocephalus [3], which are referred to as atypical forms of neurosyphilis.…”

Section: Introductionmentioning

confidence: 99%

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Hakim-Adams syndrome secondary to syphilis

Souza¹,

Zatera²,

Suzano³

et al. 2013

CRCM

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Normal pressure hydrocephalus (NPH) secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation and uncommon neuroimaging findings. A case of Syndrome de Hakim-Adams occurring in a 79year-old male was admitted for investigation of a dementia syndrome. The patient presented with clinical features and neuroimaging compatible with NPH. Syphilis serology was reactive and compatible with active disease. The patient was treated with crystalline penicillin (4 million units every 4 hours for 21 days) and was assessed again after three months, when his cognition and gait had improved and the urinary incontinence had resolved. According to this information, we describe a case of syphilis mimicking normal pressure hydrocephalus, making clear the importance of the investigation of sexually transmitted diseases in the differential diagnosis of dementia, even in patients without established risk supposedly.

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“…The first described case of neurosyphilis induced NPH was in 1979 by Amaducci, et al [5]. Other than Amaducci et al, to our knowledge there are 3 known case reports depicting NPH in the setting of neurosyphilis [6–8] In this article we describe the first case of NPH from neurosyphilis in the American Literature, a 76 year-old HIV negative male who presented with frequent falls and gait instability from known NPH caused by undiagnosed neurosyphilis.…”

Section: Introductionmentioning

confidence: 87%

Neurosyphillis presenting with normal pressure hydrocephalus in a 76 year old man

2012

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SummaryBackground: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). The subject was treated with 14 days of Intravenous (IV) Penicillin 3 million units for 3 weeks and intramuscular benzathine PCN for 2 shots, with marked clinical improvement.Conclusions:The incidence of Tabes Dorsalis is limited in the age of penicillin, especially in subjects without HIV. Subjects are diagnosed with either LP RPR or VDRL, confirmed with FTA-Abs. Common treatment is IV PCN 1.4–3 mU for 10–14 days.

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Syphilitic normal pressure hydrocephalus

Abstract: We report a case of presenile dementia with radiological and cisternographical features suggesting normal pressure hydrocephalus, caused by syphilitic infection. Treatment with penicillin resulted in considerable regression of the neurological and psychological signs.

Cited by 11 publications

References 7 publications

Neuroimaging Findings in Neurosyphilis

Neuroimaging Findings in Neurosyphilis

Hakim-Adams syndrome secondary to syphilis

Neurosyphillis presenting with normal pressure hydrocephalus in a 76 year old man

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