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Case Reports
. 2012:2012:154863.
doi: 10.1155/2012/154863. Epub 2012 Feb 16.

Neurosyphilis versus Herpes Encephalitis in a Patient with Confusion, Memory Loss, and T2-Weighted Mesiotemporal Hyperintensity

Elisa Vedes  1 , Ana Filipa Geraldo, Rita Rodrigues, Sofia Reimão, Alice Ribeiro, Francisco Antunes
Affiliations
Case Reports

Neurosyphilis versus Herpes Encephalitis in a Patient with Confusion, Memory Loss, and T2-Weighted Mesiotemporal Hyperintensity

Elisa Vedes et al. Case Rep Infect Dis. 2012.

Abstract

Acute confusion and memory loss associated with asymmetrical mesiotemporal hyperintensity on T2-weighted MRI are characteristic of herpes encephalitis. The authors report the case of a patient with these symptoms and MRI presentation who had neurosyphilis. Recently clinical and imaging patterns usually associated with herpes simplex encephalitis have been seen in patients with neurosyphilis. Because syphilis is "The Great Pretender" not only clinically but also in imaging and because its numbers are rising, it must be sought as a differential diagnosis.

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Figures

Figure 1
Figure 1
T2-weighted image on the coronal plane showing cortico-subcortical bilateral hyperintensity involving the mesiotemporal region, including amygdala and hippocampi with sulci and temporal horns enlargement.
Figure 2
Figure 2
Axial FLAIR image depicting bilateral hyperintensity of the insula more prominent on the left.
See this image and copyright information in PMC

References

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