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

Robert A Wilcox

Department of Neurology, Flinders Medical Centre, Bedford Park, SA, 5041, Australia, robert_wilcox{at}health.qld.gov.au

James Burrow

Department of Medicine, Royal Darwin Hospital, Casuarina, NT, 0811, Australia

Mark Slee

Department of Neurology, Flinders Medical Centre, Adelaide, 5042, Australia

Jamie Craig

Department of Neurology, Flinders Medical Centre, Bedford Park, SA, 5041, Australia

Dominic Thyagarajan

Department of Neurology, Flinders Medical Centre, Bedford Park, SA, 5041, Australia

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. Multiple Sclerosis 2008; 14: 268—271. http://msj.sagepub.com

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

This version was published on March 1, 2008

Multiple Sclerosis, Vol. 14, No. 2, 268-271 (2008)
DOI: 10.1177/1352458507082355
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