{
  "abstract": "Background Cases of syphilis are increasing globally. Neurosyphillis is a diagnosis that is often challenging as patients can present with a variety of neurologic manifestations, which can occur at any time after the initial infection. Early symptoms of neurosyphillis characteristically begin with a meningitis and can progress to involve cranial nerves. Here we present a case of early neurosyphillis involving the facial, trigeminal and vestibulocochlear nerves.Case A 27 year old female presented to our emergency department with around 6 weeks of headache,1 month of right sided hearing loss and several days of vertigo and left-sided hearing loss. She had sensory loss on the right side of the mouth and left tounge. She had presented to a different hospital 1 month prior with a transient right facial palsy and was diagnosed with Bell’s palsy. We performed an initial blood screen, including serologic nontreponemal and treponemal testing which was reactive. The patient was commenced on IV benzylpenicillin and subsequent CSF testing confirmed the diagnosis of neurosyphillis. Further testing confirmed severe right sensorineural hearing loss and left vestibular dysfunction in all three semicircular canals on video head impulse testing.Conclusion Otosyphillis is a known, but less commonly seen, manifestation of early neurosyphillis and may present with associated vestibular dysfunction. Neurosyphillis is an important differential diagnosis to consider in patients presenting with hearing loss and vertigo, particularly if accompanied by symptoms suggestive of meningeal irritation and/or other cranial neuropathies.",
  "authors": [
    {
      "affiliations": [
        "Neurology department, Wellington Hospital, Wellington, New Zealand"
      ],
      "name": "Jamie Mitchell"
    },
    {
      "affiliations": [
        "Neurology department, Wellington Hospital, Wellington, New Zealand"
      ],
      "name": "Duncan Smyth"
    }
  ],
  "title": "3661 A case-study of neurosyphillis involving cranial neuropathies, with prominent vestibulocochlear involvement",
  "uid": "1785b1a4-4eb5-5bbc-8f99-753804428b90"
}