A neuropsychological and neuroimaging study of a patient before and after treatment for paretic neurosyphilis

Masaru Mimura, Motoichiro Kato, Kenji Ishii, Fumihiro Yoshino, Fumie Saito, Haruo Kashima

Research output: Contribution to journalArticle

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Abstract

A 41-year-old woman suffering from paretic neurosyphilis was treated successfully with high-dose penicillin. Detailed neuropsychological and neuroimaging studies were performed before and after treatment. The patient initially presented with presbyophrenia-like features of an amnesic-confabulatory state with a hypomanic mood. Pre-treatment neuropsychological examination revealed deficits in general intelligence, attention, memory, and frontal robe executive function. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated severe hippocampal/parahippocampal damage, in addition to fronto-temporal atrophy and ventricular dilatation. Immediately after treatment, she was no longer confabulatory or hypomanic, but remained densely amnesic. Neuropsychological examination at that time revealed a significant improvement in frontal lobe function, whereas her memory was still impaired. However, CT and MRI showed no interval change. Single-photon emission CT (SPECT) demonstrated a remarkable improvement in cerebral perfusion, but the increase in frontal perfusion was relatively small. Seven months after treatment, clinical and neuropsychological examination revealed no evidence of memory impairment. Cerebral perfusion on SPECT in the frontal areas by this time had improved to normal. Positron emission tomography (PET), however, still showed patchy areas of hypoperfusion/hypometabolism. This study demonstrates the patient's stepwise clinical recovery following early antibiotic therapy and shows the dissociation of neuropsychological recovery and changes on SPECT and PET.

Original languageEnglish
Pages (from-to)275-283
Number of pages9
JournalNeurocase
Volume3
Issue number4
DOIs
Publication statusPublished - 1997
Externally publishedYes

Fingerprint

Neurosyphilis
Neuroimaging
Perfusion
Photons
Positron-Emission Tomography
Tomography
Magnetic Resonance Imaging
Executive Function
Frontal Lobe
Therapeutics
Secondary Prevention
Single-Photon Emission-Computed Tomography
Intelligence
Penicillins
Atrophy
Dilatation
Anti-Bacterial Agents
Computed Tomography
Positron Emission Tomography
Recovery

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Psychiatry and Mental health
  • Psychology(all)

Cite this

A neuropsychological and neuroimaging study of a patient before and after treatment for paretic neurosyphilis. / Mimura, Masaru; Kato, Motoichiro; Ishii, Kenji; Yoshino, Fumihiro; Saito, Fumie; Kashima, Haruo.

In: Neurocase, Vol. 3, No. 4, 1997, p. 275-283.

Research output: Contribution to journalArticle

Mimura, Masaru ; Kato, Motoichiro ; Ishii, Kenji ; Yoshino, Fumihiro ; Saito, Fumie ; Kashima, Haruo. / A neuropsychological and neuroimaging study of a patient before and after treatment for paretic neurosyphilis. In: Neurocase. 1997 ; Vol. 3, No. 4. pp. 275-283.
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