Syphilitic spinal cord gumma

Syphilitic gummas of the central nervous system are exceptional and are in general described in the brain. We report the case of a Brown-Sequard syndr ome in a 25-year-old patient. The cervical myelography and the brain CT as well as the vertebro-occipital junction were normal. The diagnosis of multi ple sclerosis was evoked and corticosteroid therapy was initiated. The pati ent experienced clinical improvement. Two years later, the patient was read mitted. Immunological reactions for syphilis were positive, in serum and CS F. Tests for HIV were negative. The MRI showed a cervical spinal cord proce ss at the C3 level with adhesive spinal associated arachnoiditis. Penicilli n therapy was started prior to surgery for the spinal process. The syphilit ic nature was confirmed by pathology. To our knowledge, the MR appearance of a syphilitic gumma of the spinal cor d has not been described previously in the scientific literature.