Neurosyphilis Mimicking Creutzfeldt-Jakob Disease.
10.12779/dnd.2016.15.4.170
- Author:
Jae Won JANG
1
;
Jeong Hoon PARK
;
Yong Jun EO
;
Seong Heon KIM
;
Kyung Ho CHOI
;
SangHak YI
;
Young Ho PARK
;
SangYun KIM
Author Information
1. Department of Neurology, Kangwon National University Hospital, Chuncheon, Korea.
- Publication Type:Case Report
- Keywords:
neurosyphilis;
general paresis;
rapidly progressive dementia;
Creutzfeldt-Jakob disease
- MeSH:
14-3-3 Proteins;
Cerebrospinal Fluid;
Creutzfeldt-Jakob Syndrome*;
Dementia;
Diagnosis;
Diagnosis, Differential;
Gait;
Humans;
Middle Aged;
Neurosyphilis*;
Plasma;
Sexually Transmitted Diseases;
Tremor
- From:Dementia and Neurocognitive Disorders
2016;15(4):170-173
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: As rapidly progressive dementia (RPD), general paresis and Creutzfeldt-Jakob disease (CJD) may have overlapping clinical presentation due to a wide variety of clinical manifestations. CASE REPORT: A 57-year-old man presented with rapid progressive cognitive decline, behavioral change, ataxic gait, tremor and pyramidal signs for 3 months. In addition to these multiple systemic involvements, positive result for the cerebrospinal fluid (CSF) 14-3-3 protein tentatively diagnosed him as probable CJD. However, due to increased serum rapid plasma reagin, venereal disease research laboratory, and fluorescent treponemal antibody-absorption reactivity in CSF, the final diagnosis was changed to general paresis. CONCLUSIONS: A patient with RPD needs to be carefully considered for differential diagnosis, among a long list of diseases. It is important to rule out CJD, which is the most frequent in RPD and is a fatal disease with no cure. Diagnostic criteria or marker of CJD, such as 14-3-3 protein, may be inconclusive, and a typical pattern in diffusion-weighted imaging is important to rule out other reversible diseases.