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Article
August 1988

Pontine Pure Motor Hemiparesis due to Meningovascular Syphilis in Human Immunodeficiency Virus-Positive Patients

Author Affiliations

The University Hospital Boston University School of Medicine Boston, MA 02118

Arch Neurol. 1988;45(8):832. doi:10.1001/archneur.1988.00520320018007
Abstract

To the Editor.  —Johns et al1 have called attention to the occurrence of a stroke syndrome of pure motor hemiparesis (PMH) in the setting of meningovascular neurosyphilis in patients with evidence of human immunodeficiency virus infection. Their two patients had magnetic resonance imaging documentation of infarction in the contralateral basis pontis as the mechanism of the PMH. These, and the following observation, suggest that this infectious central nervous system vasculitis may have a predilection for involvement of pontine branches of the basilar artery.

Report of a Case.  —A 26-year-old homosexual man developed a penile chancre one year prior to admission. Three months later, he presented with a palmar erythematous rash, positive rapid plasma reagin test results (1:1024), and a positive (3+) serum fluorescent treponemal antibody test result. He was treated with two intramuscular doses of 2.4 million units of benzathine penicillin one week apart.For two months prior to

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