{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:04:01Z","timestamp":1753891441840,"version":"3.41.2"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Neurosyphilis (NS) lacks specificity in clinical and imaging features, and patients are frequently misdiagnosed as viral encephalitis when they present with seizures. This study aimed to compare electroencephalography (EEG) in patients with seizures resulting from the two diseases and provide guidance for differential diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study on patients diagnosed with neurosyphilis and viral encephalitis with seizures in the Department of Neurology, Zhongshan Hospital, Xiamen University from 2012 to 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 39 patients with seizures caused by neurosyphilis and 40 patients with seizures caused by viral encephalitis were included. Chi-square test analysis showed that compared with patients with viral encephalitis, patients with neurosyphilis mainly developed in middle-aged and elderly people (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), were more likely to have temporal epileptiform discharges (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), and less likely to have status epilepticus (SE) (<jats:italic>p<\/jats:italic> = 0.029). There was difference between two groups in the EEG performance of lateralized periodic discharges (LPDs) (<jats:italic>p<\/jats:italic> = 0.085). The two groups were matched for age and sex by case-control matching, and 25 cases in each group were successfully matched. Patients with neurosyphilis were more likely to have temporal epileptiform discharges than those with viral encephalitis (<jats:italic>p<\/jats:italic> = 0.002), and there were no significant differences in LPDs (<jats:italic>p<\/jats:italic> = 0.077) and SE (<jats:italic>p<\/jats:italic> = 0.088) between two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When EEG shows temporal epileptiform discharges, especially in the form of LPDs, we should consider the possibility of neurosyphilis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.879643","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T05:28:45Z","timestamp":1654061325000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of Electroencephalography in Patients With Seizures Caused by Neurosyphilis and Viral Encephalitis"],"prefix":"10.3389","volume":"13","author":[{"given":"Li-Li","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-Zhen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Rong","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Yin","family":"Miao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1001\/jama.2021.23487","article-title":"Diagnosis and treatment of sexually transmitted infections: a review","volume":"327","author":"Tuddenham","year":"2022","journal-title":"J Am Med Assoc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0143304","DOI":"10.1371\/journal.pone.0143304","article-title":"Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting","volume":"10","author":"Newman","year":"2015","journal-title":"PLoS ONE."},{"key":"B3","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1177\/0956462418797873","article-title":"Atypical development of neurosyphilis mimicking limbic encephalitis","volume":"30","author":"Beiruti","year":"2019","journal-title":"Int J Std AIDS."},{"key":"B4","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.jns.2013.08.019","article-title":"Neuroimaging of six neurosyphilis cases mimicking viral encephalitis","volume":"334","author":"Xiang","year":"2013","journal-title":"J Neurol Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.seizure.2008.05.003","article-title":"Symptomatic seizures in neurosyphilis: an experience from a university hospital in south India","volume":"17","author":"Sinha","year":"2008","journal-title":"Seizure."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1212\/CON.0000000000000982","article-title":"Neurosyphilis","volume":"27","author":"Chow","year":"2021","journal-title":"Continuum."},{"key":"B7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/j.1528-1167.2008.01751.x","article-title":"Viral encephalitis and epilepsy","volume":"49","author":"Misra","year":"2008","journal-title":"Epilepsia."},{"key":"B8","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/00004691-198801000-00003","article-title":"Electroencephalography in herpes simplex encephalitis","volume":"5","author":"Lai","year":"1988","journal-title":"J Clin Neurophysiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1111\/jdv.12734","article-title":"2014 European guideline on the management of syphilis","volume":"28","author":"Janier","year":"2014","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1071\/SH21023","article-title":"The challenge of diagnosis and treatment of neurosyphilis in China: results from a nationwide survey","volume":"18","author":"Du","year":"2021","journal-title":"Sex Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"999e","DOI":"10.1111\/j.1468-1331.2010.02970.x","article-title":"Viral meningoencephalitis: a review of diagnostic methods and guidelines for management","volume":"17","author":"Steiner","year":"2010","journal-title":"Eur J Neurol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1111\/epi.13121","article-title":"A definition and classification of status epilepticus-report of the ILAE task force on classification of status epilepticus","volume":"56","author":"Trinka","year":"2015","journal-title":"Epilepsia."},{"key":"B13","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1111\/epi.13670","article-title":"Operational classification of seizure types by the international league against epilepsy: position paper of the ILAE commission for classification and terminology","volume":"58","author":"Fisher","year":"2017","journal-title":"Epilepsia."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e782","DOI":"10.1259\/bjr\/30039090","article-title":"Clinico-radiological spectrum of bilateral temporal lobe hyperintensity: a retrospective review","volume":"85","author":"Sureka","year":"2012","journal-title":"Br J Radiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1071\/SH17088","article-title":"Neurosyphilis: mighty imitator forays with benign presentation and unique neuroimaging findings","volume":"15","author":"Tiwana","year":"2018","journal-title":"Sex Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/WNP.0b013e3182784729","article-title":"American clinical neurophysiology society's standardized critical care EEG terminology: 2021 version","volume":"38","author":"Hirsch","year":"2021","journal-title":"J Clin Neurophysiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1017\/S0317167100007332","article-title":"PLEDs: clinical correlates","volume":"34","author":"Fitzpatrick","year":"2007","journal-title":"Can J Neurol Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1016\/S1388-2457(99)00119-4","article-title":"The periodicity of lateralized epileptiform discharges","volume":"110","author":"Gross","year":"1999","journal-title":"Clin Neurophysiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1053\/seiz.2000.0435","article-title":"Periodic lateralized epileptiform discharges: association with seizures","volume":"9","author":"Baykan","year":"2000","journal-title":"Seizure."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e239021","DOI":"10.1136\/bcr-2020-239021","article-title":"Prolonged postictal hemianopsia after a focal extraoccipital onset seizure","volume":"14","author":"Wasade","year":"2021","journal-title":"BMJ Case Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"49","DOI":"10.32604\/biocell.2021.013794","article-title":"miR-21-3p alleviates neuronal apoptosis during cerebral ischemia-reperfusion injury by targeting SMAD2","volume":"45","author":"Tian","year":"2021","journal-title":"Biocell."},{"key":"B22","unstructured":"Monoamine oxidase inhibitors contribute to the treatment of Alzheimer's disease111\n            MiaoW\n            WangH\n            JiaW\n            WuL\n            ZhangJ\n            HanF\n          J Compr Mol Sci Genet.22021"},{"key":"B23","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.ebcr.2015.02.001","article-title":"\u201cThe great imitator\u201d: neurosyphilis and new-onset refractory status epilepticus (NORSE) syndrome","volume":"3","author":"Kumari","year":"2015","journal-title":"Epilepsy Behav Case Rep."},{"key":"B24","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1097\/00004691-198904000-00003","article-title":"Clinical significance of periodic lateralized epileptiform discharges: relationship with status epilepticus","volume":"6","author":"Snodgrass","year":"1989","journal-title":"J Clin Neurophysiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/OLQ.0000000000001308","article-title":"A dual-platform point-of-care test for neurosyphilis diagnosis","volume":"48","author":"Gonzalez","year":"2021","journal-title":"Sex Transm Dis."},{"key":"B26","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/j.seizure.2013.05.002","article-title":"Continuous EEG predictors of outcome in patients with altered sensorium","volume":"22","author":"Rai","year":"2013","journal-title":"Seizure."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1212\/01.wnl.0000281664.02615.6c","article-title":"Electrographic seizures and periodic discharges after intracerebral hemorrhage","volume":"69","author":"Claassen","year":"2007","journal-title":"Neurology."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.879643\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T05:28:47Z","timestamp":1654061327000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.879643\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,27]]},"references-count":27,"alternative-id":["10.3389\/fneur.2022.879643"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.879643","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2022,5,27]]},"article-number":"879643"}}