Lesson of the month 1: Neurosyphilis mimicking viral encephalitis and ischaemic stroke

Viral Encephalitis Mimicking Acute Psychosis

Mesiotemporal T2-weighted hyperintensity: neurosyphilis mimicking herpes encephalitis.

Bilateral mesiotemporal hyperintensity on T2-weighted and fluid-attenuated inversion recovery MR images of a patient with a clinical syndrome of encephalitis is considered to be a classic finding for herpes simplex virus infection. We report a case of neurosyphilis with identical MR imaging abnormalities and a similar clinical presentation. Because syphilis is not routinely tested for, awarenes...

Moyamoya Disease Mimicking Encephalitis

Moyamoya disease is a rare vaso-occlusive illness with an unknown etiology characterized by stenosis of the internal carotid arteries with spontaneous development of a collateral vascular network.A 15-month-old girl was referred to the emergency ward of Imam Reza Hospital due to decreased level of consciousness, focal seizures and fever during the previous 24 hours with an impression of encepha...

Japanese viral encephalitis mimicking stroke with an initial manifestation of hemiplegia.

Japanese encephalitis (JE) is an endemic disease in Taiwan. After the program to vaccinate children against JE was implemented in 1968, the incidence of JE gradually started to decrease, but it is still an important infectious disease here. Neurological manifestations in JE vary highly during the initial stage of the disease. Focal neurological symptoms, such as hemiplegia, are rarely reported....

Neurosyphilis Mimicking Ramsay Hunt Syndrome.

A 36-year-old man presented with facial nerve palsy, hearing loss, vertigo and headache. He was initially diagnosed with Ramsay Hunt syndrome and treated with a systemic steroid and valaciclovir; however, his symptoms deteriorated. Serum rapid plasma reagin (RPR) and treponema pallidum hemagglutination tests were positive. Cerebrospinal fluid analysis revealed an elevated white blood cell count...