A Case of Optic Perineuritis Associated with Seronegative Neurosyphilis

Oh, Hyung Geun; Yang, Kwang Ik

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Case Report

Journal of the Korean Geriatrics Society 2007;11(2):98-100.
Published online June 30, 2007.

A Case of Optic Perineuritis Associated with Seronegative Neurosyphilis

Hyung Geun Oh, Kwang Ik Yang

Department of Neurology, Soonchunhyang University College of Medicine, Cheonan, Korea. neurofan@schch.co.kr

혈청음성 신경매독과 동반된 시신경주위염 1례

Abstract

Optic perineuritis is characterized by optic disc swelling with normal visual acuity, pupillary responses and intracranial pressures, and normal visual fields except for an enlarged blind spot that may be confused with papilledema caused by brain tumor or pseudotumor cerebri. It is a rare manifestation of neurosyphilis, and it is thought to represent an extension of basal meningeal inflammation to the optic nerve sheaths. Serum VDRL tests are negative in a significant proportion of patients with late syphilis, particularly in those with neurosyphilis(seronegative syphilis). We present a case of optic perineuritis associated with seronegative neurosyphilis.

Key Words: Optic perineuritis, Papilledema, Neurosyphilis

초 록

시신경주위염은 시신경유두의 부종을 보일 수 있는 질환으로 시력, 동공반응, 뇌압은 정상이고 생리적 맹점의 확대 이외에는 정상 시야를 보이는 특징이 있다. 뇌종양이나 양성 두개내압 항진증 등 뇌압상승에 의해 유발되는 유두부종과 혼동될 수 있다. 시신경주위염은 신경매독의 드문 증상으로, 뇌막의 염증반응이 시신경초까지 침범하여 나타난 것으로 생각된다. 후기 매독, 특히 신경매독의 일부 환자에서 혈청 VDRL 검사에서 음성을 보일 수 있고, 이를 혈청음성 매독이라고 한다. 저자들은 혈청음성 신경매독과 동반된 시신경주위염 1례를 경험하였기에 보고하는 바이다.

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