Limbic encephalitis is an inflammatory process of the limbic structures, with polymorphic clinical features, caused by paraneoplastic and nonparaneoplastic conditions and infections. We describe a case of neurosyphilis limbic encephalitis, presenting with reversible Geschwind syndrome (hyperreligiosity and hypergraphia) and mood disorder due to the predominant involvement of left mesial temporal structures in a previously healthy 34-year-old, left-handed woman. Because neurosyphilis can mimic common neuropsychiatric syndromes, it should be included in the differential diagnosis of psychiatric disorders with suspected general medical causes. This case of nondominant limbic encephalopathy caused by syphilis infection highlights the relevance of a careful investigation for secondary psychotic, mood, and personality disorders when assessing new-onset psychiatric illness and the importance of a multidisciplinary approach to provide a better outcome in patients with neurosyphilis.
TOFFANIN, MIOLA: Department of Neurosciences, Section of Psychiatry, University-Hospital of Padova, Padova, Italy
FOLLADOR: Department of Psychiatry, Hospital of Conegliano, ULSS 2, Treviso, Italy
FERRI: Department of Psychiatry, Hospital of Cittadella, ULSS 6, Padova, Italy
SCUPOLA: Casa di Cura Parco dei Tigli, Teolo, Padova, Italy
MARTINO and BARATTO: Unit of Radiology, Hospital of Conegliano, ULSS 2, Treviso, Italy
PERINI: Department of Neurosciences, University of Padova, and Casa di Cura Parco dei Tigli, Teolo, Padova, Italy
The authors declare no conflicts of interest.
Please send correspondence to: Tommaso Toffanin, MD, PhD, Department of Neurosciences, Section of Psychiatry, University-Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy (e-mail: email@example.com).