Sequential bilateral facial nerve palsy and gait ataxia – a rare presentation of neurosyphilis


facial nerve palsy
sexualy transmitted infections

How to Cite

Abdul Gafoor, S. M., Tilney, R., & Garcia Reitboeck, P. (2023). Sequential bilateral facial nerve palsy and gait ataxia – a rare presentation of neurosyphilis : Case Report. The Physician, 8(1), 1-9.


A middle-aged gentleman presented with sequential bilateral facial nerve palsy and ataxia. A diagnostic workup revealed positive blood serology for active syphilis infection. Interestingly, his cerebrospinal fluid was negative for syphilis. The patient responded to treatment with benzylpenicillin and made a complete recovery. Unfortunately, the diagnosis of neurosyphilis ‘still’ poses a challenge to clinicians due to insufficient ‘sensitive’ testing modalities and diagnostic criteria.

We highlight the need for a low threshold to test for syphilis in patients presenting with neurological sequelae whose diagnosis is not precise.


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