Article type: Brief Report
Article
title: Parkinsonism-plus
syndrome secondary to neurosyphilis: Case report and literature review
Journal: Neurology
India
Year: 2022
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari
Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
Background/Objective: Neurosyphilis can be associated
with a variety of clinical manifestations. There are only a few cases of
neurosyphilis associated with parkinsonism‑plus
syndromes (PPSs) that have been reported in the literature. We describe a case
of an elderly woman who presented with abnormal gait and progressive visual
disturbance, probably secondary to neurosyphilis. Methods: Literature search
was performed in Embase, Google Scholar, Medline, Scielo, and ScienceDirect
using a set of terms that included parkinsonism, tremor, and syphilis. Case
Report: A 64-year-old female was admitted because of vision problems, gait
disturbances, and cognitive impairment. The neurological examination revealed
bradykinesia, rigidity, and rest tremor. The pupils were bilaterally small and
reacted in size to a near object but did not constrict when exposed to bright
light. The conjugate eye movements showed a defective downward gaze. On
neuropsychological examination, the mini‑mental
state exam showed a moderate cognitive impairment. Reduced phonemic fluency was
observed. A positive serum venereal disease research laboratory (VDRL) test was
noted. A cerebrospinal fluid analysis showed positive VDRL. Brain and cervical
spine magnetic resonance imaging was normal. An electro-encephalogram showed
diffused slow waves. Penicillin G was started. Six months after, the patient had
a full recovery of her conjugate eye movements and cognitive functions. Upon
further questioning, the patient reported no response with a levodopa attempt. Conclusions:
To the authors’ knowledge, two individuals developed progressive supra‑nuclear palsy (PSP), and one presented corticobasal
degeneration (CBD), probably associated with neurosyphilis. This is the second case
to document the occurrence of a progressive supra‑nuclear
palsy because of syphilis.
Keywords: Corticobasal degeneration,
neurosyphilis, parkinsonism, parkinsonism-plus, progressive supra-nuclear palsy.
Full text available at:
https://www.neurologyindia.com/text.asp?2022/70/4/1635/355119
DOI
10.4103/0028-3886.355119
Citation
Rissardo JP, F. Caprara AL. Parkinsonism-plus
syndrome secondary to neurosyphilis: case report and literature review. Neurol
India 2022;70:1635-8.
