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Autoimmune limbic encephalitis or syphilitic encephalopathy? Differential diagnostic difficulties (clinical cases, literature review)
https://doi.org/10.33667/2078-5631-2025-15-50-59
Abstract
The article analyzes clinical cases of two patients with a clinical picture of acute development of memory loss, psychiatric manifestation, seizures in combination with non-structural hyperintensity from the hippocampal region on MRI of the brain, laboratory serological positivity in non-treponemal and treponemal tests and signs of intrathecal immunoreactivity with a preliminary diagnosis of limbic encephalitis. The diagnostic difficulties in establishing a final diagnosis are emphasized and attention is focused on the completeness of the examination. Clinical, instrumental and laboratory features of late neurosyphilis in the form of syphilitic encephalopathy and limbic encephalitis, which have similar manifestations, are considered. The increase in the frequency of false diagnosis of autoimmune encephalitis determines the importance of a demanding attitude to differential clinical and paraclinical studies that help in determining the pathogenesis of these complex pathologies.
About the Authors
D. I. Skulyabin
Department of Nervous Diseases, S. M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Skulyabin Dmitry I., PhD Med, senior lecturer at Dept of Neurology
A. S. Agafina
Saint Petersburg City Hospital No. 40
Russian Federation
Russian Federation
Agafina Alina S., PhD Med, head of Preclinical and Clinical Trial Unit
S. V. Lapin
Scientific and Methodological Center for Molecular Medicine, Laboratory of Autoimmune Diseases Diagnostic at First Pavlov State Medical University of St. Petersburg
Russian Federation
Russian Federation
Lapin Sergey V., PhD Med, head of Laboratory of Autoimmune Diseases Diagnostic
D. A. Kuznetsova
Scientific and Methodological Center for Molecular Medicine, Laboratory of Autoimmune Diseases Diagnostic at First Pavlov State Medical University of St. Petersburg
Russian Federation
Russian Federation
Kuznetsova Darya A., PhD Med, clinical laboratory diagnostics doctor, laboratory geneticist doctor
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For citations:
Skulyabin D.I., Agafina A.S., Lapin S.V., Kuznetsova D.A. Autoimmune limbic encephalitis or syphilitic encephalopathy? Differential diagnostic difficulties (clinical cases, literature review). Medical alphabet. 2025;(15):50-59. (In Russ.) https://doi.org/10.33667/2078-5631-2025-15-50-59
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