Background: While Parkinsonism plus syndrome (PPS) is one of several atypical manifestations in neurosyphilis patients, its clinical features and brain-related manifestations are inadequately documented. In this cross-sectional study, we endeavored to indicate some key clinical and imaging features of neurosyphilis patients, particularly those specific to PPS.
Methods: We retrospectively included all syphilis patients enrolled in the study from January 2021 to February 2024. All in all, 54 neurosyphilis patients with PPS were recruited. Their socio-demographical features, clinical status, presentations, laboratory manifestations and neuroimaging were analyzed retrospectively.
Results: The predominant phenotype was general paresis (GP). Median age at onset was 50 years, and 87.0 % of the patients were male. Bradykinesia (53.7 %) was the most common manifestation of PPS in neurosyphilis patients. The most frequent physical sign was orofacial dyskinesia (the Candy sign), which accounted for 51.9 % of cases. In nearly three quarters (71.1 %), magnetic resonance imagery revealed temporal, hippocampal lobe, or whole brain atrophy, while 13.3 % exhibited basal ganglia lacunar infarction, and 22.2 % cases had focal demyelination in the cerebral peduncle, cerebellum, frontal lobe, parietal lobe, hippocampus and/or lateral vertical.
Conclusions: Neurosyphilis patients exhibited PPS in involving bradykinesia, tremor rigidity and, in most cases, GP. Brain atrophy and basal ganglia lesion were the most common imaging findings in neurosyphilis patients with PPS. Our results should help to elucidate PPS characteristics PPS and neuroimaging mechanisms in neurosyphilis patients with PPS.
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http://dx.doi.org/10.1016/j.idnow.2024.105009 | DOI Listing |
Neuropsychiatr Dis Treat
December 2024
Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China.
Purpose: To investigate whole-brain gray matter volume (GMV) changes in human immunodeficiency (HIV)-negative patients with general paresis of the insane (GPI) using voxel-based morphometry (VBM).
Patients And Methods: A total of 18 HIV-negative individuals with GPI and 24 healthy control volunteers matched for sex, age, and education were enrolled in this study. 3 D T1-weighted imaging (3D T1WI) structural images of GPI patients and healthy controls were preprocessed using VBM.
Eur J Med Res
December 2024
Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China.
Background: Neurosyphilis (NS) is the most serious complication elicited by the invasion of Treponema pallidum (T. pallidum) into the central nervous system. Identifying the neuro-invasion of T.
View Article and Find Full Text PDFInt J STD AIDS
December 2024
Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta.
The resurgence of syphilis across Europe has led to a growing number of atypical cases, often characterised by varied symptoms that can delay diagnosis. We report the case of a young man who has sex with men (MSM), presenting with persistent headaches and swelling of the forehead suggestive of giant cell arteritis (GCA). Despite a recent negative syphilis test, further investigations confirmed the diagnosis of neurosyphilis.
View Article and Find Full Text PDFFront Med (Lausanne)
November 2024
Department of Neurosurgery, The Ganzhou Affiliated Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, Jiangxi, China.
Background: Cerebral syphilitic gumma (CSG), a rare manifestation of neurosyphilis, presents characteristics akin to intracranial tumors, often leading to clinical misdiagnosis.
Objective: This study aimed to summarize the clinical experience in diagnosing and treating CSG.
Materials And Methods: The present study conducted a retrospective analysis of clinical data, encompassing the baseline characteristics, clinical presentation, diagnosis, treatment, and prognosis of eight patients with CSG who were treated and diagnosed by our institution.
Front Neurol
November 2024
Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Purpose: This study aimed to investigate ocular manifestations in patients with neurosyphilis and their association with general indexes.
Methods: This retrospective study was conducted among patients who were hospitalized for neurosyphilis from 2012 to 2022. Clinical manifestations, laboratory tests, brain MRI, and ocular examinations were reviewed and analyzed.
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