Neurosyphilis masquerading as oculomotor nerve palsy in a healthy middle-aged man: Case report and review of the literature
Fares Antaki,
Kenan Bachour,
Milanne Trottier,
Laurent Létourneau-Guillon,
Jacinthe Rouleau
Affiliations
Fares Antaki
Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada; Corresponding author at: Department of Ophthalmology, Centre Hospitalier de l’Université de Montréal, 1051 Rue Sanguinet, Montréal, QC, H2X 3E4, Canada.
Kenan Bachour
Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
Milanne Trottier
Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
Laurent Létourneau-Guillon
Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
Jacinthe Rouleau
Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
Acquired isolated oculomotor nerve palsy (ONP) is a commonly encountered clinical entity in ophthalmology. While most cases are due to microvascular ischemia, the diagnosis of ONP requires careful evaluation for alternate life-threatening etiologies. We present a case of isolated complete pupil-involving ONP in a healthy 47-year-old man in whom aneurysmal compression was initially suspected. Investigations later revealed a diagnosis of neurosyphilis. Neurosyphilis is an extremely rare cause of isolated ONP and seldom reported in the literature. Timely recognition of this disease by ophthalmologists can help orient patients to the appropriate neurology and infectious disease services they need.
