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Letters   |    
Neurosyphilis Presenting as Primary Progressive Aphasia
Panagiotis Ioannidis, M.D., Ph.D.; Athanasios Lourbopoulos, M.D., Ph.D.; Dimitra Mamouli, M.D.; Eleni Polichroniadou, M.D.; George Papadopoulos, M.D.; Dimitris Karacostas, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E27-E28. doi:10.1176/appi.neuropsych.13010018
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The authors report no conflict of interest related to the present study.

Dept. of Neurology, AHEPA University Hospital, Aristotle University School of Medicine, Thessaloniki, Macedonia, Greece

Correspondence: Dr. Ioannidis; e-mail: ioannidispanosgr@yahoo.gr

Copyright © 2014 by the American Psychiatric Association

Extract

To the Editor: Primary progressive nonfluent aphasia (PPnfA) is an aphasic disorder that is classified in the spectrum of frontotemporal dementia diseases.1 It is characterized by disturbed grammatical comprehension and expression, as well as reduction of speech sound production. We present a adult man whose initial symptoms and signs were compatible with PPnfA in whom later work-up surprisingly unmasked neurosyphilis.

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FIGURE 1. Neurosyphilis Patient’s MRI

[A]: T1-weighted image with contrast medium; [B]: T2-weighted image shows ventricular enlargement due to parenchymal atrophy, incompatible with his age.

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References

Gorno-Tempini  ML;  Hillis  AE;  Weintraub  S  et al:  Classification of primary progressive aphasia and its variants.  Neurology 2011; 76:1006–1014
[CrossRef] | [PubMed]
 
Nagappa  M;  Sinha  S;  Taly  AB  et al:  Neurosyphilis: MRI features and their phenotypic correlation in a cohort of 35 patients from a tertiary care university hospital.  Neuroradiology 2013; 55:379–388; available at doi: 10.1007/s00234-012-1017-9
[CrossRef] | [PubMed]
 
Yu  Y;  Wei  M;  Huang  Y  et al:  Clinical presentation and imaging of general paresis due to neurosyphilis in patients negative for human immunodeficiency virus.  J Clin Neurosci 2010; 17:308–310
[CrossRef] | [PubMed]
 
Mayer  KH;  Mimiaga  MJ:  Resurgent syphilis in the United States: urgent need to address an evolving epidemic.  Ann Intern Med 2011; 155:192–193
[CrossRef] | [PubMed]
 
Ghanem  KG:  Review: Neurosyphilis: a historical perspective and review.  CNS Neurosci Ther 2010; 16:e157–e168
[CrossRef] | [PubMed]
 
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