Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review
Neurosyphilis is a rare but life-threatening complication of syphilis that can develop even decades after the primary infection and can be unrecognized. Seizures and status epilepticus (SE) may represent the first manifestation in a previously undiagnosed syphilitic patient. We present an exemplific...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | NeuroSci |
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| Online Access: | https://www.mdpi.com/2673-4087/2/4/31 |
| _version_ | 1827670593330216960 |
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| author | Giada Giovannini Stefano Meletti |
| author_facet | Giada Giovannini Stefano Meletti |
| author_sort | Giada Giovannini |
| collection | DOAJ |
| description | Neurosyphilis is a rare but life-threatening complication of syphilis that can develop even decades after the primary infection and can be unrecognized. Seizures and status epilepticus (SE) may represent the first manifestation in a previously undiagnosed syphilitic patient. We present an exemplification case of a new onset refractory status epilepticus caused by neurosyphilis and we reviewed the existing literature. We selected all studies reporting cases of SE in the context both of patients with a known diagnosis of syphilis and as the first manifestation of neurosyphilis. We identified 50 patients, mostly composed of immunocompetent, middle-aged males. Thirty-nine patients (83%) presented a new onset SE. A history of subtle and rapidly progressive mood and/or cognitive impairment suggesting a limbic encephalitis-like presentation was frequently observed. Focal frontal or temporal SE was reported in 26. Brain MRI frequently showed T2/FLAIR hyperintensities widely involving the medial temporal structures and the frontal lobes. This review should increase the clinician’s awareness of neurosyphilis as a possible etiology of a new onset SE of unknown etiology, especially in the context of a “limbic encephalitis”-like clinical presentation. Prompt recognition and treatment for neurosyphilis partially or completely reverse neurologic sequelae, changing the natural history of the disease. |
| first_indexed | 2024-03-10T03:25:13Z |
| format | Article |
| id | doaj.art-4147b4463ce54484b9c7a6b6fc933648 |
| institution | Directory Open Access Journal |
| issn | 2673-4087 |
| language | English |
| last_indexed | 2024-03-10T03:25:13Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | NeuroSci |
| spelling | doaj.art-4147b4463ce54484b9c7a6b6fc9336482023-11-23T09:53:46ZengMDPI AGNeuroSci2673-40872021-12-012441642610.3390/neurosci2040031Status Epilepticus and Neurosyphilis: A Case Report and a Narrative ReviewGiada Giovannini0Stefano Meletti1Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, 41126 Modena, ItalyNeurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, 41126 Modena, ItalyNeurosyphilis is a rare but life-threatening complication of syphilis that can develop even decades after the primary infection and can be unrecognized. Seizures and status epilepticus (SE) may represent the first manifestation in a previously undiagnosed syphilitic patient. We present an exemplification case of a new onset refractory status epilepticus caused by neurosyphilis and we reviewed the existing literature. We selected all studies reporting cases of SE in the context both of patients with a known diagnosis of syphilis and as the first manifestation of neurosyphilis. We identified 50 patients, mostly composed of immunocompetent, middle-aged males. Thirty-nine patients (83%) presented a new onset SE. A history of subtle and rapidly progressive mood and/or cognitive impairment suggesting a limbic encephalitis-like presentation was frequently observed. Focal frontal or temporal SE was reported in 26. Brain MRI frequently showed T2/FLAIR hyperintensities widely involving the medial temporal structures and the frontal lobes. This review should increase the clinician’s awareness of neurosyphilis as a possible etiology of a new onset SE of unknown etiology, especially in the context of a “limbic encephalitis”-like clinical presentation. Prompt recognition and treatment for neurosyphilis partially or completely reverse neurologic sequelae, changing the natural history of the disease.https://www.mdpi.com/2673-4087/2/4/31status epilepticusnew onset refractory status epilepticussyphilisneurosyphilislueetiology |
| spellingShingle | Giada Giovannini Stefano Meletti Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review NeuroSci status epilepticus new onset refractory status epilepticus syphilis neurosyphilis lue etiology |
| title | Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review |
| title_full | Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review |
| title_fullStr | Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review |
| title_full_unstemmed | Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review |
| title_short | Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review |
| title_sort | status epilepticus and neurosyphilis a case report and a narrative review |
| topic | status epilepticus new onset refractory status epilepticus syphilis neurosyphilis lue etiology |
| url | https://www.mdpi.com/2673-4087/2/4/31 |
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