An autopsy case of Lissauer's general paresis with rapidly progressive left hemiparesis

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  • 急速に進行する片麻痺を呈したＬｉｓｓａｕｅｒ型進行麻痺の１剖検例
  • 症例報告 急速に進行する片麻痺を呈したLissauer型進行麻痺の1剖検例
  • ショウレイ ホウコク キュウソク ニ シンコウ スル ヘンマヒ オ テイシタ Lissauerガタ シンコウ マヒ ノ 1 ボウケンレイ

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A 48-years old man presented with slowly progressive bradykinesia, personality change and rapidly progressive left hemiparesis. On admission, he presented dementia, poor judgment, left hemiparesis. MRI revealed a widespread high intensity area in right hemisphere and MRA was almost normal. Serological tests of serum and CSF demonstrated high titers of antibodies to Treponema pallidum. He was treated for syphilis with daily penicillin injections without improvement. He died of sepsis eight months after admission.<br> At autopsy, the brain weighed 1,100g and the right cerebral hemisphere was atrophic, especially in frontal base, temporal, parietal, angular, and posterior regions covered by thickened, fibrotic leptomeninges. Microscopically, chronic meningoencephalitis was observed. Severe neuronal loss with gliosis was seen in the right cerebral cortices. Scattered rod-shaped microglia and inflammatory cell infiltration were visible in the cerebral parenchyma. The dorsal column of the spinal cord was not involved and meningovascular syphilis was unclear. The distribution of the encephalitic lesions was well correlated with the clinical and neuroradiological findings. This was a rare autopsy case presenting Lissauer's general paresis, clinically manifesting as rapidly progressive stroke-like episode.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 49 (6), 348-353, 2009

    Societas Neurologica Japonica

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