A 34-year-old man required intensive care unit admission for recurrent seizures. He had a 1-year history of unexplained psychiatric illness, with depression, catatonia, cognitive decline, psychosis and persecutory delusions, unresponsive to antipsychotics and antidepressants. His MR scan of brain suggested autoimmune encephalitis1 (figures 1–3). Electroencephalogram (figure 4) identified non-convulsive status epilepticus. Cerebrospinal fluid (CSF) analysis was inflammatory, with a white cell count of 2 x 109/L (≤5), protein 1.02 g/L (0.15–0.45) and glucose 5.0 mmol/L (plasma 5.6). Serum treponemal and Venereal Disease Research Laboratory (VDRL) tests were positive, with VDRL titres in serum of 1:16 and in CSF of 1:32. Serologies for HIV and other sexually transmitted diseases were negative. Malignancy screening was negative, including …

中文翻译：

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神经梅毒伪装成自身免疫性脑炎

一名 34 岁男子因反复癫痫发作而需要入住重症监护室。他有1年不明原因精神疾病史，伴有抑郁、紧张症、认知能力下降、精神病和被害妄想，对抗精神病药物和抗抑郁药物无反应。他的大脑 MR 扫描提示患有自身免疫性脑炎1（图 1-3）。脑电图（图 4）确定为非惊厥性癫痫持续状态。脑脊液 (CSF) 分析显示炎症，白细胞计数为 2 x 109/L (≤5)，蛋白质为 1.02 g/L (0.15–0.45)，葡萄糖为 5.0 mmol/L（血浆 5.6）。血清密螺旋体和性病研究实验室 (VDRL) 检测呈阳性，血清中的 VDRL 滴度为 1:16，脑脊液中的滴度为 1:32。艾滋病毒和其他性传播疾病的血清学结果呈阴性。恶性肿瘤筛查呈阴性，包括……