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• Vol.49 No.6
• CLINICA NEUROL, 49: 348−353, 2009
• Vol.49 No.6 contents

Case Report

An autopsy case of Lissauer's general paresis with rapidly progressive left hemiparesis

Hiroko Kato, M.D.¹⁾, Mari Yoshida, M.D.²⁾, Tetsuo Ando, M.D.¹⁾, Makoto Sugiura, M.D.¹⁾ and Yoshio Hashizume, M.D.²⁾

¹⁾Department of Neurology, Anjo Kosei Hospital
²⁾Institute for Medical Science of Aging, Aichi Medical University

A 48-years old man presented with slowly progressive bradykinesia, personality change and rapidly progressive left hemiparesis. On admission, he presented dementia, poor judgment, left hemiparesis. MRI revealed a widespread high intensity area in right hemisphere and MRA was almost normal. Serological tests of serum and CSF demonstrated high titers of antibodies to Treponema pallidum. He was treated for syphilis with daily penicillin injections without improvement. He died of sepsis eight months after admission.
At autopsy, the brain weighed 1,100 g and the right cerebral hemisphere was atrophic, especially in frontal base, temporal, parietal, angular, and posterior regions covered by thickened, fibrotic leptomeninges. Microscopically, chronic meningoencephalitis was observed. Severe neuronal loss with gliosis was seen in the right cerebral cortices. Scattered rod-shaped microglia and inflammatory cell infiltration were visible in the cerebral parenchyma. The dorsal column of the spinal cord was not involved and meningovascular syphilis was unclear. The distribution of the encephalitic lesions was well correlated with the clinical and neuroradiological findings. This was a rare autopsy case presenting Lissauer's general paresis, clinically manifesting as rapidly progressive stroke-like episode.
Full Text of this Article in Japanese PDF (1561K)

(CLINICA NEUROL, 49: 348−353, 2009)
key words: Lissauer's general paresis, hemiparesis, dementia, MRI, chronic meningoencephalitis

(Received: 18-Jul-08)