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Multiple Sclerosis
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*Syphilis
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Article

Neuromyelitis optica (Devic's disease) in a patient with syphilis

Robert Wilcox1*, James Burrow2, Mark Slee3, Jamie Craig1, and Dominic Thyagarajan1

1 Department of Neurology, Flinders Medical Centre, Bedford Park, SA, 5041, Australia
2 Department of Medicine, Royal Darwin Hospital, Casuarina, NT, 0811, Australia
3 Department of Neurology, Flinders Medical Centre, Adelaide, 5042, Australia

* To whom correspondence should be addressed.


  Abstract

The patient initially presented with bilateral optic neuritis and periventricular cranial MRI abnormalities in the context of syphilis. Blood was positive but cerebrospinal fluid testing was negative for specific syphilis markers and he was oligoclonal cerebrospinal fluid (CSF) band negative. He initially responded well to penicillin and corticosteriod treatment, but went on to develop the clinical syndrome of neuromyelitis optica (NMO). Testing for the presence of the serum autoantibody for aquaporin- 4 was negative. This patient appears to represent another case of post-infectious NMO. Possible pathogenesis of this post-syphilis NMO syndrome in the patient is discussed.

Key Words: aquaporin-4 antibody; Devic's disease; neuromyelitis optica; NMO; syphilis

First published on November 6, 2007, doi:10.1177/1352458507082355

Multiple Sclerosis 2008;14:268.

A more recent version of this article appeared on March 1, 2008

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