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Intractable Epilepsy as the Initial Manifestation of Neurosyphilis

Summary: A 29‐year‐old man experienced intractable partial seizures as the initial manifestation of neurosyphilis. The diagnosis was made after the onset of dementia 9 months later. Both the epilepsy and dementia resolved with penicillin therapy. Syphilis should be considered in patients with adult‐onset focal epilepsy, particularly if there is associated dementia. Treatment may be successful even when the diagnosis is delayed.