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以孤立性展神经麻痹为表现的神经梅毒

Neurosyphilis Presenting with Isolated Abducens Nerve Palsy.

作者信息

Mukai Taiji, Hokkoku Keiichi, Kitazawa Takatoshi, Oba Hiroshi, Hatanaka Yuki, Sonoo Masahiro, Kobayashi Shunsuke

机构信息

Department of Neurology, Teikyo University School of Medicine, Japan.

出版信息

Intern Med. 2025 Mar 15;64(6):917-919. doi: 10.2169/internalmedicine.4098-24. Epub 2024 Aug 8.

DOI:10.2169/internalmedicine.4098-24
PMID:39111883
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11986314/
Abstract

We herein report a case of neurosyphilis that presented with isolated bilateral abducens nerve palsy. A 39-year-old man was referred to our department with diplopia. He had a history of homosexual relationships and showed only bilateral abducens nerve palsy upon a neurological examination. Positive syphilis tests in the serum and cerebrospinal fluid and a contrasting effect on the abducens nerve on magnetic resonance imaging (MRI) confirmed the diagnosis of active neurosyphilis. When a patient manifests isolated abducens nerve palsy, neurosyphilis can be a differential diagnosis, although rare, and contrast-enhanced MRI may help diagnose the disease.

摘要

我们在此报告一例以孤立性双侧展神经麻痹为表现的神经梅毒病例。一名39岁男性因复视被转诊至我科。他有同性恋史，神经系统检查仅显示双侧展神经麻痹。血清和脑脊液梅毒检测呈阳性，磁共振成像（MRI）显示展神经有强化效应，确诊为活动性神经梅毒。当患者表现为孤立性展神经麻痹时，神经梅毒虽罕见但可作为鉴别诊断，增强MRI可能有助于该病的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/369f/11986314/7768de4c7f61/1349-7235-64-0917-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/369f/11986314/7768de4c7f61/1349-7235-64-0917-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/369f/11986314/7768de4c7f61/1349-7235-64-0917-g001.jpg

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本文引用的文献

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Isolated abducens nerve palsy: Comparison of microvascular and other causes.孤立性展神经麻痹：微血管性病因与其他病因的比较。
North Clin Istanb. 2022 Sep 5;9(4):353-357. doi: 10.14744/nci.2021.15483. eCollection 2022.
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An Updated Review of Recent Advances in Neurosyphilis.神经梅毒近期进展的最新综述
Front Med (Lausanne). 2022 Sep 20;9:800383. doi: 10.3389/fmed.2022.800383. eCollection 2022.
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Clinical outcomes and etiology of acquired sixth cranial nerve palsy.获得性第六颅神经麻痹的临床结果和病因。
Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029102.
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Isolated Cranial Nerve VI Palsy and Neurosyphilis: A Case Report and Review of Related Literature.孤立性动眼神经麻痹与神经梅毒：一例报告及相关文献综述
IDCases. 2022 Jan 5;27:e01377. doi: 10.1016/j.idcr.2022.e01377. eCollection 2022.
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Neurosyphilis masquerading as oculomotor nerve palsy in a healthy middle-aged man: Case report and review of the literature.一名健康中年男性中伪装为动眼神经麻痹的神经梅毒：病例报告及文献复习
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Neurosyphilis in AIDS patient presenting as isolated cranial nerve 6 palsy.艾滋病患者出现孤立性展神经麻痹的神经梅毒。
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Neurosyphilis presenting as cranial nerve palsy, an entity which is easy to miss.以颅神经麻痹为表现的神经梅毒，这是一种容易被漏诊的病症。
BMJ Case Rep. 2019 Feb 21;12(2):e226509. doi: 10.1136/bcr-2018-226509.
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Early neurosyphilis presenting with multiple cranial nerve palsies: A case report of management by combined penicillin-corticosteroid treatment.以多发性颅神经麻痹为表现的早期神经梅毒：青霉素联合皮质类固醇治疗的病例报告
J Infect Chemother. 2019 May;25(5):362-364. doi: 10.1016/j.jiac.2018.11.007. Epub 2018 Dec 8.
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Treatment of Syphilis-Associated Cerebral Vasculitis: Reappearance of an Old Question.梅毒相关性脑血管炎的治疗：旧问题重现。
Am J Med. 2018 Dec;131(12):1516-1519. doi: 10.1016/j.amjmed.2018.06.005. Epub 2018 Jul 2.
10
Oculomotor nerve palsy as the presenting symptom of gummatous neurosyphilis and human immunodeficiency virus infection: clinical response to treatment.
JAMA Neurol. 2013 Dec;70(12):1582-3. doi: 10.1001/jamaneurol.2013.1485.