Abstract：
The patient was a 32-year-old man with no HIV infection and possible syphilis infection at the age of 22 years. At the age of 29 years, he visited an ophthalmologist for diplopia due to right oculomotor nerve palsy. He underwent diplopia strabismus surgery for unexplained oculomotor nerve palsy. At the age of 31 years, he had a left oculomotor nerve palsy and was referred to our department. He was diagnosed with neurosyphilis based on positive serum and cerebrospinal fluid syphilis antibodies. MRI showed aneurysm, asymptomatic cerebral hemorrhage, and contrast enhancement of the left oculomotor nerve, leading to the diagnosis of meningovascular syphilis. The patient\'s symptoms improved with penicillin and corticosteroids. The oculomotor nerve palsy may be due to microcirculatory disorder caused by syphilitic cerebral endarteritis.
摘要：
该患者是一名32岁的男性，在22岁时没有HIV感染和可能的梅毒感染。在29岁的时候，他因右侧动眼神经麻痹而求诊了一位眼科医生。他因无法解释的动眼神经麻痹而接受了复视斜视手术。在31岁的时候，他患有左动眼神经麻痹，被转诊到我们部门。根据血清和脑脊液梅毒抗体阳性，他被诊断为神经梅毒。MRI显示动脉瘤,无症状脑出血,左动眼神经的对比增强，导致诊断为脑膜血管梅毒。使用青霉素和皮质类固醇，患者的症状得到改善。动眼神经麻痹可能是由于梅毒性脑动脉内膜炎引起的微循环障碍。
