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• Vol.62 No.11
• CLINICA NEUROL, 62: 873−876, 2022
• Vol.62 No.11 contents

Brief Clinical Note

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

Shin Soeda, M.D.¹⁾, Hiroyuki Onoue, M.D., Ph.D.¹⁾, Yawara Shinmura, M.D.²⁾, Satoshi Ebihara, M.D., Ph.D.²⁾, Tone Suzuki, M.D., Ph.D.²⁾, Yasuhisa Akaiwa, M.D., Ph.D.¹⁾ and Tomoyuki Miyamoto, M.D., Ph.D.¹⁾

¹⁾ Department of Neurology, Dokkyo Medical University Saitama Medical Center
²⁾ Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center

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.
Full Text of this Article in Japanese PDF (1715K)

(CLINICA NEUROL, 62: 873−876, 2022)
key words: neurosyphilis, oculomotor nerve palsy, cerebral hemorrhage, cerebral aneurysm, meningovascular syphilis

(Received: 13-Jan-22)