Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis

BackgroundNeurosyphilis (NS) lacks specificity in clinical and imaging features, and patients are frequently misdiagnosed as viral encephalitis when they present with seizures. This study aimed to compare electroencephalography (EEG) in patients with seizures resulting from the two diseases and prov...

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Main Authors: Li-Li Zheng, Jing-Zhen Chen, Xiao-Rong Zhuang, Jia-Yin Miao
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-05-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2022.879643/full
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author Li-Li Zheng
Jing-Zhen Chen
Xiao-Rong Zhuang
Jia-Yin Miao
author_facet Li-Li Zheng
Jing-Zhen Chen
Xiao-Rong Zhuang
Jia-Yin Miao
author_sort Li-Li Zheng
collection DOAJ
description BackgroundNeurosyphilis (NS) lacks specificity in clinical and imaging features, and patients are frequently misdiagnosed as viral encephalitis when they present with seizures. This study aimed to compare electroencephalography (EEG) in patients with seizures resulting from the two diseases and provide guidance for differential diagnosis.MethodsA retrospective study on patients diagnosed with neurosyphilis and viral encephalitis with seizures in the Department of Neurology, Zhongshan Hospital, Xiamen University from 2012 to 2020.ResultsA total of 39 patients with seizures caused by neurosyphilis and 40 patients with seizures caused by viral encephalitis were included. Chi-square test analysis showed that compared with patients with viral encephalitis, patients with neurosyphilis mainly developed in middle-aged and elderly people (p < 0.001), were more likely to have temporal epileptiform discharges (p < 0.001), and less likely to have status epilepticus (SE) (p = 0.029). There was difference between two groups in the EEG performance of lateralized periodic discharges (LPDs) (p = 0.085). The two groups were matched for age and sex by case-control matching, and 25 cases in each group were successfully matched. Patients with neurosyphilis were more likely to have temporal epileptiform discharges than those with viral encephalitis (p = 0.002), and there were no significant differences in LPDs (p = 0.077) and SE (p = 0.088) between two groups.ConclusionWhen EEG shows temporal epileptiform discharges, especially in the form of LPDs, we should consider the possibility of neurosyphilis.
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spelling doaj.art-ef8acdf8478c465bba9e983e2028d70f2022-12-22T00:23:31ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.879643879643Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral EncephalitisLi-Li ZhengJing-Zhen ChenXiao-Rong ZhuangJia-Yin MiaoBackgroundNeurosyphilis (NS) lacks specificity in clinical and imaging features, and patients are frequently misdiagnosed as viral encephalitis when they present with seizures. This study aimed to compare electroencephalography (EEG) in patients with seizures resulting from the two diseases and provide guidance for differential diagnosis.MethodsA retrospective study on patients diagnosed with neurosyphilis and viral encephalitis with seizures in the Department of Neurology, Zhongshan Hospital, Xiamen University from 2012 to 2020.ResultsA total of 39 patients with seizures caused by neurosyphilis and 40 patients with seizures caused by viral encephalitis were included. Chi-square test analysis showed that compared with patients with viral encephalitis, patients with neurosyphilis mainly developed in middle-aged and elderly people (p < 0.001), were more likely to have temporal epileptiform discharges (p < 0.001), and less likely to have status epilepticus (SE) (p = 0.029). There was difference between two groups in the EEG performance of lateralized periodic discharges (LPDs) (p = 0.085). The two groups were matched for age and sex by case-control matching, and 25 cases in each group were successfully matched. Patients with neurosyphilis were more likely to have temporal epileptiform discharges than those with viral encephalitis (p = 0.002), and there were no significant differences in LPDs (p = 0.077) and SE (p = 0.088) between two groups.ConclusionWhen EEG shows temporal epileptiform discharges, especially in the form of LPDs, we should consider the possibility of neurosyphilis.https://www.frontiersin.org/articles/10.3389/fneur.2022.879643/fullneurosyphilisencephalitisviralseizureselectroencephalography
spellingShingle Li-Li Zheng
Jing-Zhen Chen
Xiao-Rong Zhuang
Jia-Yin Miao
Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis
Frontiers in Neurology
neurosyphilis
encephalitis
viral
seizures
electroencephalography
title Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis
title_full Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis
title_fullStr Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis
title_full_unstemmed Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis
title_short Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis
title_sort comparison of electroencephalography in patients with seizures caused by neurosyphilis and viral encephalitis
topic neurosyphilis
encephalitis
viral
seizures
electroencephalography
url https://www.frontiersin.org/articles/10.3389/fneur.2022.879643/full
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AT xiaorongzhuang comparisonofelectroencephalographyinpatientswithseizurescausedbyneurosyphilisandviralencephalitis
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