Highlights
- •Neurosyphilitic basal meningitis causes acute unilateral peripheral vestibulopathy with involvement of adjacent cranial nerves.
- •The mechanism of neurosyphilis is basal meningitis.
- •Neurosyphilis can occur early in the secondary phase or later in the latent phase.
Abstract
Introduction
Neurosyphilis producing basal meningitis presenting as sequential transient cranial
nerve palsies was well recognized before the antibiotic era.
Objective
To report two patients presenting with acute unilateral peripheral vestibulopathy
due to syphilitic basal meningitis.
Results
In Case 1 basal meningitis occurred early in the secondary phase of the infection,
in Case 2 in the late latent phase. The diagnosis was not made immediately in either
case; in Case 1 after previous presentation with increasing hearing loss and then
with facial palsy and then a subsequent presentation with optic neuritis; in Case
2 after investigation for possible lymphoma.
Conclusion
Syphilitic basal meningitis in either the secondary or in the latent phase can present
as acute unilateral peripheral vestibulopathy with transient involvement of the facial
or auditory nerve.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Changes in neurosyphilis presentation: a survey on 286 patients.J. Eur. Acad. Dermatol. Venereol. 2016; 30: 1886-1900
- The video head impulse test (vHIT) of semicircular canal function–age-dependent normative values of VOR gain in healthy subjects.Front. Neurol. 2015; 6
- Human ocular torsional position before and after unilateral vestibular neurectomy.Exp. Brain Res. 1991; 85: 218-225
- Vestibular-evoked myogenic potentials.Handb. Clin. Neurol. 2016; 137: 133
- Syphilitic uveitis and optic neuritis in Sydney Australia.Br. J. Ophthalmol. 2015; 99: 1215-1219
- Laboratory diagnosis and interpretation of tests for syphilis.Clin. Microbiol. Rev. 1995; 8: 1-21
- Acute syphilitic meningitis.Medicine. 1935; 14: 119-183
- Generalized lymphadenopathy and 18-fluorine fluorodeoxyglucose positron emission tomography/computed tomography: targeting diagnostic intervention, characterizing disease extent, and assessing treatment efficacy in syphilis.Sex. Transm. Dis. 2015; 42: 68-70
- On syphilis and the ear—an otologist's view.Genitourin. Med. 1992; 68: 420
- Otosyphilis: a review of 85 cases.Otolaryngol. Head Neck Surg. 2007; 136: 67-71
- Endolymphatic hydrops in otologic syphilis: a temporal bone study.Otology & Neurotology. 2010; 31: 681-686
- HIV-associated neurosyphilis mimicking acoustic neurinoma.J. Neurol. 2006; 253: 250-252
- Sudden-onset bilateral deafness revealing early neurosyphilis.Eur. Ann. Otorhinolaryngol. Head Neck Dis. 2014; 131: 389-391
- Cochleovestibular involvement as the first sign of syphilis.J. Neurol. 1978; 219: 199-204
- Neurosyphilis as a cause of facial and vestibulocochlear nerve dysfunction: MR imaging features.AJNR Am. J. Neuroradiol. 2000; 21: 1673-1675
- Simultaneous optic and vestibulocochlear syphilitic neuropathy in a patient with HIV infection.J. ophthalmic inflamm. infect. 2013; 3: 1
- Cochleovestibular deficit as first manifestation of syphilis in a HIV-infected patient.Case reports in neurology. 2013; 5: 62-67
- Neurosyphilis presenting with gummatous oculomotor nerve palsy.J. Neurol. Neurosurg. Psychiatry. 2004; 75: 789
- Syphilis mimicking idiopathic intracranial hypertension.BMJ case reports. 2011; (2011:bcr0920114813)
Article info
Publication history
Published online: April 23, 2017
Accepted:
April 21,
2017
Received in revised form:
April 6,
2017
Received:
January 18,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
