![]() No visual alterations were found during dilated fundus examination, electronic visual field or confrontation examination, and the rest of the cranial nerves were normal. Neurological examination revealed mixed aphasia subsiding with the administration of steroids. She referred one episode of seizures without specifying the characteristics, but they were apparently tonic-clonic. She attended our offices due to alterations in language, mixed aphasia and moderate holocranial headache, with no attenuating or exacerbating factors, no predominance at a certain time of day, and subsiding spontaneously. ![]() Case reportĪ 50-year-old female patient with a history of controlled systemic arterial hypertension and poor diet, with no history of sexual risk behaviour. In this article we present the case of a 50-year-old patient and we provide a literature review. It is a rare brain finding observed during tertiary syphilis that can sometimes simulate different neoplastic brain lesions, confusing diagnosis and treatment. ![]() In America, an incidence of 2.8 million and prevalence of 6.7 million is estimated, and it is therefore considered to be a public health problem. In 2008, the World Health Organisation (WHO) reported an incidence of 10.6 million and a prevalence of 36.4 million, with more than 90% of cases occurring in developing countries. The most common form of transmission is through sexual relations, but in some cases vertical transmission occurs, from the mother to the foetus. It is a systemic infectious disease caused by a spirochaete, Treponema pallidum. Syphilis is one of the many types of sexually-transmitted diseases. La neurosífilis gomatosa es una presentación infrecuente, por lo que la mayoría de las veces se llega a un diagnóstico y tratamiento erróneo, motivo por el cual reportamos nuestro caso y realizamos revisión de la bibliografía. Se inicia nuevamente tratamiento endovenoso con penicilina benzatinica, y se realizan nuevos controles, serológicos y de imagen, encontrándose la ausencia de las lesiones. Se realiza nueva RMN de control y se observa recidiva de lesión tumoral en región temporal izquierda. Recibe tratamiento para neurosífilis por 5 semanas, y teniendo mejoría al mes de control, pero presentando nuevamente a los 6 meses del tratamiento, alteraciones del habla, con afasia sensitiva. Cuenta con imágenes de RMN y TAC demostrando lesión parietal izquierda en primera instancia, y posteriormente recidiva en temporal izquierdo. Presenta solo cefalea y alteraciones del habla (afasia mixta). Se presenta el caso de una mujer de 50 años sin alteraciones de importancia, en la conducta sexual, e inmunocompetente. La sífilis es una enfermedad sistémica causada por la espiroqueta Treponema pallidum que compromete al sistema nervioso central en cualquier etapa y cuyas presentaciones clínicas se modificaron en las últimas décadas, debido a la aparición del virus de la inmunodeficiencia adquirida. It is for this reason that we have presented our case study and literature review. Gummatous neurosyphilis is a rare condition, which explains why it tends to be erroneously diagnosed and treated. Intravenous treatment was once again initiated with benzathine penicillin and new serological and imaging tests were conducted, revealing the absence of lesions. Another control MRI was performed, revealing a relapse of the tumour lesion in the left temporal region. The patient was treated for neurosyphilis for 5 weeks and showed improvement at her one-month follow-up appointment, before once again manifesting speech disturbances with sensory aphasia six months after treatment onset. MRI and CT scans initially showed left parietal injury, and later left temporal recurrence. We present the case of a 50-year-old immunocompetent woman with no significant changes in sexual behaviour, who only presented with headache and speech disturbances (mixed aphasia). Syphilis is a systemic disease caused by the spirochaete Treponema pallidum that affects the central nervous system at any time and whose clinical presentation has undergone changes in recent decades, due to the emergence of the acquired immune deficiency virus. ![]()
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