Lissauer form of paretic neurosyphilis with a cerebral mass lesion

Nitrini, Ricardo; Zambón, Antonio A.; Hirsh, Roberto; Rosemberg, Sérgio; Scaff, M.

doi:10.1590/S0004-282X1988000300014

Abstracts

A 40-year-old male patient with progressive dementia presented adversive seizures, and CT scan showed an enlarging focal mass lesion in the right cerebral hemisphere. Cerebrospinal fluid examination and brain biopsy confirmed the diagnosis of neurosyphilis. After a course of penicillin therapy there was disappearance of the cerebral mass lesion and the CT scan showed focal atrophy in the right cerebral hemisphere. This case suggests that Lissauer form of paretic neurosyphilis may present as a focal mass lesion.

Registro de caso de paciente do sexo masculino com 40 anos de idade em que a tomografia computadorizada revelou a presença de processo expansivo no hemisfério cerebral direito. Os exames do líqüido cefalorraqueano e biópsia cerebral evidenciaram as características de neurossífilis. Após penicilinoterapia foi constatada atrofia focal no hemisfério cerebral direito. Este caso sugere que a forma de Lissauer da paralisia geral progressiva pode manifestar-se como processo expansivo cerebral.

Ricardo Nitrini^I; Antonio A. Zambón^I; Roberto Hirsh^I; Sérgio Rosemberg^II; M. Scaff^I

^IDepartment of Neurology - Faculty of Medicine, São Paulo University

^IIDepartment of Pathology - Faculty of Medicine, São Paulo University

SUMMARY

A 40-year-old male patient with progressive dementia presented adversive seizures, and CT scan showed an enlarging focal mass lesion in the right cerebral hemisphere. Cerebrospinal fluid examination and brain biopsy confirmed the diagnosis of neurosyphilis. After a course of penicillin therapy there was disappearance of the cerebral mass lesion and the CT scan showed focal atrophy in the right cerebral hemisphere. This case suggests that Lissauer form of paretic neurosyphilis may present as a focal mass lesion.

RESUMO

Registro de caso de paciente do sexo masculino com 40 anos de idade em que a tomografia computadorizada revelou a presença de processo expansivo no hemisfério cerebral direito. Os exames do líqüido cefalorraqueano e biópsia cerebral evidenciaram as características de neurossífilis. Após penicilinoterapia foi constatada atrofia focal no hemisfério cerebral direito. Este caso sugere que a forma de Lissauer da paralisia geral progressiva pode manifestar-se como processo expansivo cerebral.

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Divisão de Neurologia, Hospital das Clínicas da FMUSP - Caixa Postal 3461 - 01051 São Paulo SP - Brasil.

1. Cohen MS, Gibson G, Olarte MR - Lissauer form of paretic neurosyphilis: forgotten but not gone. Ann Neurol 12: 219, 1982.
2. Eltomey AA, Olin MS, Roberts MP - Cerebellopontine angle gumma. Neurosurgery 15: 252, 1984.
3. Escobar A, Nieto D - Neurosyphilis. In Minckler J (ed): Pathology of the Nervous System. McGraw-Hill, New York, 1972, pg 2448.
4. Gabay EL, Hallinan J, Lovett MA - Computerized tomographic findings in meningo-vascular syphilis: a case report. Sex Transm Dis 10: 39, 1983.
5. Godt P, Stoeppler L, Wischer U, Schroeder HH - The value of computed tomography in cerebral syphilis. Neuroradiology 18: 197, 1979.
6. Goulon M, Raphael JC, Chesneau AM, Brunei D, Lamer C - Gomme syphilitique cérébrale operée. Rev Neurol (Paris) 142-228, 1986.
7. Greenfield JG - Infectious diseases of the central nervous system. In Blackwood W et al. (eds): Greenfield's Neuropathology. Edward Arnold, London, 1971, pg 138.
8. Hwang WZ, Hasegawa T, Ito H, Shimoji T, Yamamoto S - Cerebral gumma: case report. J Neurosurg 63: 301, 1985.
9. Kaplan JG, Sterman AB, Horoupian D, Leeds NE, Zimmerman RD, Gade R - Luetic meningitis with gumma: clinical, radiographic and neuropathologic features. Neurology 31: 464, 1981.
10. Kulla L, Russel JA, Smith TW, Zito JL, Davidson R - Neurosyphilis presenting as a focal mass lesion: a case report. Neurosurgery 14: 234, 1984.
11. Merritt HH, Springlova M - Lissauer's dementia paralytica: a clinical and pathological study. Arch Neurol Psychiat 27: 987, 1932.
12. Michel D, Blanc A, Laurent B, Foyatier N, Portafaix M - Etude biologique, psychométrique et tomodensimétrique de la neurosyphilis traitée. Rev Neurol (Paris) 139: 737, 1983.
13. Punt J - Multiple cerebral gummata: case report. J Neurosurg 58: 959, 1983.

Lissauer form of paretic neurosyphilis with a cerebral mass lesion

Forma de Lissauer da paralisia geral progressiva com lesão expansiva cerebral

Publication Dates

Publication in this collection
17 June 2011
Date of issue
Sept 1988

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Cohen MS, Gibson G, Olarte MR - Lissauer form of paretic neurosyphilis: forgotten but not gone. Ann Neurol 12: 219, 1982.

[2] 2. Eltomey AA, Olin MS, Roberts MP - Cerebellopontine angle gumma. Neurosurgery 15: 252, 1984.

[3] 3. Escobar A, Nieto D - Neurosyphilis. In Minckler J (ed): Pathology of the Nervous System. McGraw-Hill, New York, 1972, pg 2448.

[4] 4. Gabay EL, Hallinan J, Lovett MA - Computerized tomographic findings in meningo-vascular syphilis: a case report. Sex Transm Dis 10: 39, 1983.

[5] 5. Godt P, Stoeppler L, Wischer U, Schroeder HH - The value of computed tomography in cerebral syphilis. Neuroradiology 18: 197, 1979.

[6] 6. Goulon M, Raphael JC, Chesneau AM, Brunei D, Lamer C - Gomme syphilitique cérébrale operée. Rev Neurol (Paris) 142-228, 1986.

[7] 7. Greenfield JG - Infectious diseases of the central nervous system. In Blackwood W et al. (eds): Greenfield's Neuropathology. Edward Arnold, London, 1971, pg 138.

[8] 8. Hwang WZ, Hasegawa T, Ito H, Shimoji T, Yamamoto S - Cerebral gumma: case report. J Neurosurg 63: 301, 1985.

[9] 9. Kaplan JG, Sterman AB, Horoupian D, Leeds NE, Zimmerman RD, Gade R - Luetic meningitis with gumma: clinical, radiographic and neuropathologic features. Neurology 31: 464, 1981.

[10] 10. Kulla L, Russel JA, Smith TW, Zito JL, Davidson R - Neurosyphilis presenting as a focal mass lesion: a case report. Neurosurgery 14: 234, 1984.

[11] 11. Merritt HH, Springlova M - Lissauer's dementia paralytica: a clinical and pathological study. Arch Neurol Psychiat 27: 987, 1932.

[12] 12. Michel D, Blanc A, Laurent B, Foyatier N, Portafaix M - Etude biologique, psychométrique et tomodensimétrique de la neurosyphilis traitée. Rev Neurol (Paris) 139: 737, 1983.

[13] 13. Punt J - Multiple cerebral gummata: case report. J Neurosurg 58: 959, 1983.