Acute confusion and memory loss associated with asymmetrical mesiotemporal hyperintensity on T2-weighted MRI are characteristic\r\nof herpes encephalitis. The authors report the case of a patient with these symptoms and MRI presentation who had\r\nneurosyphilis. Recently clinical and imaging patterns usually associated with herpes simplex encephalitis have been seen in patients\r\nwith neurosyphilis. Because syphilis is ââ?¬Å?The Great Pretenderââ?¬Â not only clinically but also in imaging and because its numbers are\r\nrising, it must be sought as a differential diagnosis.
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