Objective: To report two cases of Parkinsonism secondary to neurosyphilis.

Background: Neurosyphilis can cause various neurological manifestations, but rarely Parkinsonism.

Methods: We collect information, clinical data and imaging data from 2 cases of Parkinsonism.

Results: The first patient is a 58-year-old male, with a complaint of bradykinesia, muscle rigidity, blurred speech and decline in cognition(UPDRS:59; MMSE score: 20). He is not responsive to Levo-dopa. His serum test is positive for syphilis. After treatment with peniciline for 14 days, he recovered from Parkisonism(UPDRS: 37) and his MMSE score was 25. The second patient is 60-year-old male, who showed tremor in his right hand, blurred speech, decline in cognition. He is not responsive to Levo-dopa either. On examination, Argyll-Robertson pupil and ocular vertical dyskinesia was found. His serum test for syphilis was also positive. After treatment with peniciline for 4 weeks, there was a recovery in his walking and ocular vertical dyskinesia, but tremor and decline in cognition persisted.

Conclusions: In clinical practice, when the cause of Parkinsonism is unclear and the treatment with Levo-dopa is not significant, a test for syphilis should be underwent. Treatment with anti-syphilis may be effective, especially in early stage.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/2-cases-of-parkinonism-secondary-to-neurosyphilis/