Man with Confusion and Irregular Small Pupils

Saturday, November 13, 2010
65 years old male presented with confusion and irregular small pupils that react to near objects, but not to light.Further neurological examination revealed ataxic wide-based gait and foot slap, areflexia and loss of position.



What is the probable diagnosis?

ANSWER

Tertiary Syphilis,Gumma in Bone and Symptoms suggestive of Argyll-Robertson pupil and Tabes dorsalis, also known as locomotor ataxia
There is an irregular lytic area in the left frontal bone, which variably involves the whole thickness of the vault. The process seems to have extended down the coronal suture into the anterior part of sphenoid. Compare with normal diploic vessels. Otherwise vault markings are normal without any increase in vascular markings. The dorsum sellae appears intact.

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18 comments

  1. Anonymous Says:
  2. Stroke

     
  3. Anonymous Says:
  4. wernicke encepalopathy

     
  5. Anonymous Says:
  6. Neurosyphillis

     
  7. Domenico Says:
  8. Paget's disease

     
  9. Anonymous Says:
  10. Neurosyphilis with Argyl Robertson pupils.

     
  11. Anonymous Says:
  12. neurosyphillis wid argyll robertson pupil also know as prostitute's pupil (accomodation positive but reaction to light absent)

     
  13. Anonymous Says:
  14. neurosyphillis wid argyll robertson pupil also know as prostitute's pupil (accomodate but do not react)

     
  15. Anonymous Says:
  16. Padget's indeed

     
  17. Anonymous Says:
  18. tertiary syphillus also called neurosyphillus with argyl robertsons(prostitues pupli) that accomodates but doesnt react to light!.

     
  19. Anonymous Says:
  20. wernicke encepalopathy

     
  21. Anonymous Says:
  22. right otomastoiditis with inflamatory petrositis and with cerebelar abcces and cavernous tromboflebitis

     
  23. Anonymous Says:
  24. give your basis in establishing the diagnosis..

     
  25. Anonymous Says:
  26. tertiary syphilis

     
  27. Anonymous Says:
  28. multiple myeloma

     
  29. Anonymous Says:
  30. neurosyphilis and treat it wit penicillin if allergic then desensitize with penicillin

     
  31. Hello and congratulations for the site,

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  32. Anonymous Says:
  33. gumma

     
  34. Anonymous Says:
  35. Tertiary syphilis with argyll-Robertson pupils and tabes dorsalis

     

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