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- Yui Sanpei, Akira Hanazono, Momoka Funasaka, Keita Yasuda, Yoshiko Takahashi, and Masashiro Sugawara.
- Department of Neurology, Akita University Graduate School of Medicine, Japan.
- Intern. Med. 2024 Nov 28.
AbstractWe herein report a 48-year-old man with neurosyphilis manifesting as limbic encephalitis, initially suspected to be autoimmune limbic encephalitis. The patient exhibited rapid behavioral changes, and magnetic resonance imaging showed high-intensity lesions in both medial temporal lobes. The diagnosis was based on symptoms, cerebrospinal fluid abnormalities, and positive serum tests for syphilis. Notably, the cerebrospinal fluid immunoglobulin G index was markedly elevated (4.91). This case highlights the diagnostic challenges in differentiating neurosyphilis from autoimmune limbic encephalitis, given the increasing atypical presentation. A markedly elevated immunoglobulin G index may serve as a valuable diagnostic indicator for neurosyphilis in such cases.
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